Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain
Background. There has been a dramatic increase in obesity in the United States. Several studies have reported conflicting results for the impact of obesity on outcomes of liver transplantation (LT). This study aims to assess the impact of obesity on LT and changes in body mass index (BMI) after tran...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-02-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001242 |
| _version_ | 1818952601268387840 |
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| author | Daiki Soma, MD, PhD Yujin Park, MD Plamen Mihaylov, MD Burcin Ekser, MD, PhD Marwan Ghabril, MD Marco Lacerda, MD Naga Chalasani, MD Richard S. Mangus, MD Chandrashekhar A. Kubal, MD, PhD |
| author_facet | Daiki Soma, MD, PhD Yujin Park, MD Plamen Mihaylov, MD Burcin Ekser, MD, PhD Marwan Ghabril, MD Marco Lacerda, MD Naga Chalasani, MD Richard S. Mangus, MD Chandrashekhar A. Kubal, MD, PhD |
| author_sort | Daiki Soma, MD, PhD |
| collection | DOAJ |
| description | Background. There has been a dramatic increase in obesity in the United States. Several studies have reported conflicting results for the impact of obesity on outcomes of liver transplantation (LT). This study aims to assess the impact of obesity on LT and changes in body mass index (BMI) after transplantation.
Methods. All adult LTs performed at Indiana University between 2001 and 2018 were reviewed. BMIs of recipients were subdivided into 6 categories. Survival outcomes were compared across the subgroup. BMI was followed up in a cohort of patients from 2008 to 2018.
Results. Among 2024 patients, 25% were in class I obesity, 9.3% were in class II obesity, and 1.1% were in class III obesity. There was no significant difference in patient and graft survival at 10-y follow-up with respect to BMI. Among 1004 patients in the subgroup, BMI of all groups except the underweight group declined in the first 3 mo postoperatively; however, the BMI of all groups except the class III obesity group returned to the pre-LT level by 2 y and reached a plateau by 5 y. In the class III obesity group, there was a significant increase in body weight at 5 y.
Conclusions. Class III obesity was not associated with higher mortality in our cohort. Because our cohort is small, it may be underpowered to detect a smaller difference in outcome. From our observation, obesity should not be considered a contraindication for LT. Post-LT interventions are required to prevent significant weight gain for the class III obesity group. |
| first_indexed | 2024-12-20T09:52:58Z |
| format | Article |
| id | doaj.art-68dcd8c6b38d41e9adf7d1072d2f32e1 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-12-20T09:52:58Z |
| publishDate | 2022-02-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-68dcd8c6b38d41e9adf7d1072d2f32e12022-12-21T19:44:33ZengWolters KluwerTransplantation Direct2373-87312022-02-0182e124210.1097/TXD.0000000000001242202202000-00001Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight GainDaiki Soma, MD, PhD0Yujin Park, MD1Plamen Mihaylov, MD2Burcin Ekser, MD, PhD3Marwan Ghabril, MD4Marco Lacerda, MD5Naga Chalasani, MD6Richard S. Mangus, MD7Chandrashekhar A. Kubal, MD, PhD81 Division of Transplantation, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.1 Division of Transplantation, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.1 Division of Transplantation, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.1 Division of Transplantation, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.2 Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN.2 Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN.2 Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN.1 Division of Transplantation, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.1 Division of Transplantation, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.Background. There has been a dramatic increase in obesity in the United States. Several studies have reported conflicting results for the impact of obesity on outcomes of liver transplantation (LT). This study aims to assess the impact of obesity on LT and changes in body mass index (BMI) after transplantation. Methods. All adult LTs performed at Indiana University between 2001 and 2018 were reviewed. BMIs of recipients were subdivided into 6 categories. Survival outcomes were compared across the subgroup. BMI was followed up in a cohort of patients from 2008 to 2018. Results. Among 2024 patients, 25% were in class I obesity, 9.3% were in class II obesity, and 1.1% were in class III obesity. There was no significant difference in patient and graft survival at 10-y follow-up with respect to BMI. Among 1004 patients in the subgroup, BMI of all groups except the underweight group declined in the first 3 mo postoperatively; however, the BMI of all groups except the class III obesity group returned to the pre-LT level by 2 y and reached a plateau by 5 y. In the class III obesity group, there was a significant increase in body weight at 5 y. Conclusions. Class III obesity was not associated with higher mortality in our cohort. Because our cohort is small, it may be underpowered to detect a smaller difference in outcome. From our observation, obesity should not be considered a contraindication for LT. Post-LT interventions are required to prevent significant weight gain for the class III obesity group.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001242 |
| spellingShingle | Daiki Soma, MD, PhD Yujin Park, MD Plamen Mihaylov, MD Burcin Ekser, MD, PhD Marwan Ghabril, MD Marco Lacerda, MD Naga Chalasani, MD Richard S. Mangus, MD Chandrashekhar A. Kubal, MD, PhD Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain Transplantation Direct |
| title | Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain |
| title_full | Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain |
| title_fullStr | Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain |
| title_full_unstemmed | Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain |
| title_short | Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain |
| title_sort | liver transplantation in recipients with class iii obesity posttransplant outcomes and weight gain |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001242 |
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