Strengthening the Road to Recovery

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Study finds decline in muscle strength may affect lung transplantation outcomes.
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Lung transplantation is a lengthy, complex surgical procedure that requires extensive clinical follow up and lifelong use of drugs that suppress the immune system.
Eighteen days. That’s how long the patient who received the first lung transplant lived. It wasn’t until 20 years later, after multiple attempts had been made around the world, that a successful long-term lung transplant was performed here at the Toronto General Hospital. That patient lived for more than six years.
Lung transplantation survival rates have greatly improved since then: four out of five patients live for at least five years and about a third make it to ten years. 
Increasingly, however, older patients—who have more complexity due to age-related health issues—are being offered the surgery. 
TRI Affiliate Scientist Dr. Sunita Mathur has been working to better understand the physiological factors that might affect lung transplantation outcomes in these patients. Her team recently conducted a study to determine if age-related changes in muscle function and strength influence transplantation outcomes.  
The team measured muscle mass and muscle strength in a group of lung transplant candidates, with an average age of 59 years, before their surgery. The candidates’ exercise capacity was also measured using a six-minute walk test, while quality of life was assessed using a questionnaire.
The team found that a majority of the lung transplant candidates in the study showed signs of muscle dysfunction, which was associated with poor physical performance in the walk test and lower quality of life. These patients were also more likely to have longer hospital stays after their transplant.
“This the first study to demonstrate that changes in muscle strength and physical performance affect lung transplantation outcomes,” explains Dr. Mathur. “It suggests that modifying muscle performance before the surgery may improve post-transplant outcomes.” 
D. Rozenberg was supported by  the Vanier Canada Graduate Scholarship program, an American Society of Transplantation Fellowship and the University of Toronto Clinician Scientist Training Program.
Rozenberg D, Singer LG, Herridge M, Goldstein R, Wickerson L, Chowdhury NA, Mathur S. Evaluation of Skeletal Muscle Function in Lung Transplant Candidates. Transplantation. 2017 Sep;101(9):2183-2191. doi: 10.1097/TP.0000000000001754.