{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:02:57Z","timestamp":1791378177957,"version":"4.3.2"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Pre\u2010transplant sarcopenia predicts adverse outcomes in adult kidney transplant recipients. Whether this association extends to pediatric populations\u2014who exhibit distinct immunological profiles, growth dynamics, and adherence challenges\u2014remains unknown. We investigated the relationship between computed tomography (CT)\u2010quantified body composition and graft outcomes in children.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Single\u2010center retrospective cohort study of 46 pediatric kidney transplant recipients (age\u2009<\u200918\u2009years) with preoperative T12\u2010level CT imaging (2020\u20132024). Skeletal muscle area (SMA), intermuscular adipose tissue (IMAT), skeletal muscle density (SMD), and skeletal muscle index (SMI) were measured. The primary outcome was a composite endpoint of graft failure, defined as permanent return to dialysis (hemodialysis or peritoneal dialysis), re\u2010transplantation, or death from any cause. Univariable Cox models were the primary analyses; multivariable models were exploratory given limited events (\n n<\/jats:italic>\n \u2009=\u200912).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Transplant recipients had significantly lower SMA (61.05 vs. 65.54\u2009cm\n 2<\/jats:sup>\n ,\n p<\/jats:italic>\n \u2009=\u20090.049), IMAT (0.80 vs. 1.72\u2009cm\n 2<\/jats:sup>\n ,\n p<\/jats:italic>\n \u2009<\u20090.001), and BMI (17.30 vs. 20.41\u2009kg\/m\n 2<\/jats:sup>\n ,\n p<\/jats:italic>\n \u2009<\u20090.001). Over a median follow\u2010up of 45\u2009months, 12 patients experienced the primary outcome. Univariable Cox regression revealed no statistically significant association between the primary outcome and SMA (HR 0.99, 95% CI 0.96\u20131.03), IMAT (HR 1.18, 95% CI 0.73\u20131.90), SMD (HR 1.04, 95% CI 0.94\u20131.15), or SMI (HR 0.98, 95% CI 0.85\u20131.13). Multivariable models, conducted as exploratory sensitivity analyses, yielded consistent non\u2010significant results.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n No statistically significant association was detected between pre\u2010transplant body composition parameters and adverse outcomes in this cohort of pediatric kidney transplant recipients. These preliminary findings suggest caution in directly extrapolating adult sarcopenia thresholds to children and highlight the need for larger, adequately powered pediatric studies to develop age\u2010specific risk stratification tools.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/petr.70459","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:19:25Z","timestamp":1791375565000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre\u2010Transplant\n CT<\/scp>\n Body Composition and Graft Outcomes in Pediatric Kidney Transplant Recipients: Revisiting the Adult Paradigm"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9306-1728","authenticated-orcid":false,"given":"Min","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"},{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoyu","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengting","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruyi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7332-3490","authenticated-orcid":false,"given":"Bingfeng","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3369-8532","authenticated-orcid":false,"given":"Liling","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Guangxi Medical University Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"588","DOI":"10.23876\/j.krcp.23.331","article-title":"Global Burden and Risk Factors of Chronic Kidney Disease in Adolescents and Young Adults: A Study From 1990 to 2019","volume":"44","author":"Deng H.","year":"2025","journal-title":"Kidney Research and Clinical Practice"},{"issue":"6","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/j.pcl.2022.07.010","article-title":"Chronic Kidney Disease in Children","volume":"69","author":"VanSickle J. 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