Jose Alvarez1, Xioanon Mei1, Michael Daily1, Malay Shah1, Alla Grigorian2, Jonathan Berger1, Francesc Marti1, Roberto Gedaly3. 1. Department of Surgery, University of Kentucky College of Medicine Transplant Center, 800 Rose Street, C451, Lexington, KY, 40536-0293, USA. 2. Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Kentucky College of Medicine, Lexington, KY, USA. 3. Department of Surgery, University of Kentucky College of Medicine Transplant Center, 800 Rose Street, C451, Lexington, KY, 40536-0293, USA. rgeda2@uky.edu.
Abstract
OBJECTIVE: We aim to study outcomes in liver transplant recipients with body mass index (BMI) ≥50 using the United Network for Organ Sharing (UNOS) database. METHODS: We reviewed patients undergoing liver transplantation recorded in the UNOS database from 1988 to 2013. Of 104,250 liver transplant procedures, 123 were performed on super obese patients. RESULTS: Sixty-four percent of the super obese patients are female (64 %) and had a mean age 47 years (20-71). The mean BMI was 53.5 (50-72.86) and 16 % had diabetes. The mean Model for End-Stage Disease (MELD) score at transplant was 29.1 (6-53). It was found that BMI ≥50 increased 1.6-fold the risk of death within 30 days after liver transplantation. Graft failure was increased by 52 % and overall mortality was by 62 %. A 1:1 propensity score-matched analysis demonstrated that patients with BMI <50 have significantly better graft and overall patient survival than the super obese. CONCLUSIONS: Overall, our data shows that BMI ≥50 is an independent predictor of perioperative mortality and graft and overall patient survival. Further studies are necessary to better understand predictors of outcomes in super obese patients.
OBJECTIVE: We aim to study outcomes in liver transplant recipients with body mass index (BMI) ≥50 using the United Network for Organ Sharing (UNOS) database. METHODS: We reviewed patients undergoing liver transplantation recorded in the UNOS database from 1988 to 2013. Of 104,250 liver transplant procedures, 123 were performed on super obesepatients. RESULTS: Sixty-four percent of the super obesepatients are female (64 %) and had a mean age 47 years (20-71). The mean BMI was 53.5 (50-72.86) and 16 % had diabetes. The mean Model for End-Stage Disease (MELD) score at transplant was 29.1 (6-53). It was found that BMI ≥50 increased 1.6-fold the risk of death within 30 days after liver transplantation. Graft failure was increased by 52 % and overall mortality was by 62 %. A 1:1 propensity score-matched analysis demonstrated that patients with BMI <50 have significantly better graft and overall patient survival than the super obese. CONCLUSIONS: Overall, our data shows that BMI ≥50 is an independent predictor of perioperative mortality and graft and overall patient survival. Further studies are necessary to better understand predictors of outcomes in super obesepatients.
Entities:
Keywords:
Liver transplantation; Outcomes; Super obesity
Authors: Ashish Singhal; Gregory C Wilson; Koffi Wima; R Cutler Quillin; Madison Cuffy; Nadeem Anwar; Tiffany E Kaiser; Flavio Paterno; Tayyab S Diwan; E Steve Woodle; Daniel E Abbott; Shimul A Shah Journal: Transpl Int Date: 2015-02 Impact factor: 3.782
Authors: N Nguyen; J K Champion; J Ponce; B Quebbemann; E Patterson; B Pham; W Raum; J N Buchwald; G Segato; F Favretti Journal: Obes Surg Date: 2012-06 Impact factor: 4.129
Authors: Trevor W Reichman; George Therapondos; Maria-Stella Serrano; John Seal; Rachel Evers-Meltzer; Humberto Bohorquez; Ari Cohen; Ian Carmody; Emily Ahmed; David Bruce; George E Loss Journal: World J Hepatol Date: 2015-06-18
Authors: Shawn J Pelletier; Martin A Maraschio; Douglas E Schaubel; Dawn M Dykstra; Jeffrey D Punch; Robert A Wolfe; Friedrich K Port; Robert M Merion Journal: Clin Transpl Date: 2003
Authors: Shawn J Pelletier; Douglas E Schaubel; Guanghui Wei; Michael J Englesbe; Jeffrey D Punch; Robert A Wolfe; Friedrich K Port; Robert M Merion Journal: Liver Transpl Date: 2007-12 Impact factor: 5.799