Current Pulmonology Reports

, Volume 7, Issue 3, pp 101–106 | Cite as

It's What’s Inside that Counts: Body Composition and Lung Transplantation

  • Jessica Lau
  • Erin F. Barreto
  • Anupam Kumar
  • Cassie C. KennedyEmail author
Lungs Transplant (R Bag, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lung Transplant


Purpose of Review

Factors such as weight, body composition, and functional status appear to influence lung transplant outcomes. Body mass index (BMI) is incorporated into the International Society for Heart and Lung Transplantation’s (ISHLT) recipient selection guidelines. Data suggests BMI does not effectively differentiate patients with high body fat percentage or low lean muscle mass, leading to both over and under estimates of candidates’ risks.

Recent Findings

Recent research has focused on alternate measures and estimates of body composition and their associations with important lung transplant outcomes. Herein, we review the current literature on body composition in lung transplantation, including the variety of measurements used and the concepts of obesity, low muscle mass, and frailty.


The concept of body composition is evolving beyond the relationship between weight and height as represented by a calculated body mass index. Radiographic assessments and serum markers allow for a more precise and representative measurement of body composition which takes into consideration fat percentage and muscle mass.


Lung transplant Body composition Body mass index Obesity Lean body mass Sarcopenia Frailty 



body mass index


computed tomography


creatinine height index


cross-sectional area


intensive care unit


magnetic resonance imaging


sarcopenia index


whole body dual X-ray absorptiometry


Financial Support

CCK and EFB are supported by the Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN. CCK is also supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number K23HL128859.

Compliance with Ethical Standards

Conflict of Interest

Erin Barreto is on the advisory board for FAST Biomedical, outside the submitted work. Cassie Kennedy, Anupam Kumar and Jessica Lau declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


The manuscript’s contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jessica Lau
    • 1
  • Erin F. Barreto
    • 2
    • 3
  • Anupam Kumar
    • 4
  • Cassie C. Kennedy
    • 1
    • 3
    • 5
    Email author
  1. 1.Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterUSA
  2. 2.Department of Pharmacy ServicesMayo ClinicRochesterUSA
  3. 3.Robert D. and Patricia E. Kern Center for the Science of Health Care DeliveryMayo ClinicRochesterUSA
  4. 4.Division of Pulmonary & Critical Care, Richard DeVos Heart & Lung Transplant ProgramSpectrum Health-Michigan State University College of Human MedicineGrand RapidsUSA
  5. 5.William J. von Liebig Center for Transplantation and Clinical RegenerationMayo ClinicRochesterUSA

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