The impact of obesity on long-term outcomes in liver transplant recipients - Results of the NIDDK Liver Transplant Database

J. Leonard, J. K. Heimbach, M. Malinchoc, K. Watt, M. Charlton

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

The impact of obesity on outcomes following liver transplantation has been difficult to determine, in part due to the confounding effects of ascites on BMI. We evaluated the impact of pretransplant recipient obesity on outcomes following liver transplantation using the NIDDK Liver Transplantation Database. Pretransplant BMI, corrected for ascites, was categorized as underweight (BMI <18 kg/m2), normal weight (BMI 18-25 kg/m2), overweight (BMI 25.1-30 kg/m2), Class I obese (BMI 30.1-35 kg/m2), Class II obese (BMI 35.1-40 kg/m2) and Class III obese (BMI >40 kg/m2). Primary outcomes were patient and graft survival. Secondary outcomes included days in hospital and days in ICU. Data from 704 adult liver transplant recipients from the NIDDK LTD and a further 609 patients from the Mayo Clinic were analyzed. Early and late patient and graft survival was similar across all BMI categories. Correcting for ascites volume resulted in 11-20% of patients moving into a lower BMI classification. The relative risk for mortality increased by 7% for each liter of ascites removed. We conclude that corrected BMI is not independently predictive of patient or graft survival. Obesity, within the ranges observed in this study, should not be considered to be a contraindication to liver transplantation in the absence of other relative contraindications.

Original languageEnglish (US)
Pages (from-to)667-672
Number of pages6
JournalAmerican Journal of Transplantation
Volume8
Issue number3
DOIs
StatePublished - Mar 2008

Fingerprint

National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)
Ascites
Liver Transplantation
Graft Survival
Obesity
Databases
Transplants
Liver
Moving and Lifting Patients
Thinness
Mortality
Transplant Recipients

Keywords

  • Liver transplantation
  • Obesity
  • Outcomes research

ASJC Scopus subject areas

  • Immunology

Cite this

The impact of obesity on long-term outcomes in liver transplant recipients - Results of the NIDDK Liver Transplant Database. / Leonard, J.; Heimbach, J. K.; Malinchoc, M.; Watt, K.; Charlton, M.

In: American Journal of Transplantation, Vol. 8, No. 3, 03.2008, p. 667-672.

Research output: Contribution to journalArticle

Leonard, J. ; Heimbach, J. K. ; Malinchoc, M. ; Watt, K. ; Charlton, M. / The impact of obesity on long-term outcomes in liver transplant recipients - Results of the NIDDK Liver Transplant Database. In: American Journal of Transplantation. 2008 ; Vol. 8, No. 3. pp. 667-672.
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