The impact of obesity as determined by modified body mass index on long-term outcome after liver transplantation: Canadian single-center experience

T Tanaka; E L Renner; N Selzner; G Therapondos; L B Lilly

doi:10.1016/j.transproceed.2012.11.009

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The impact of obesity as determined by modified body mass index on long-term outcome after liver transplantation: Canadian single-center experience

Journal article

Peer reviewed

The impact of obesity as determined by modified body mass index on long-term outcome after liver transplantation: Canadian single-center experience

T Tanaka, E L Renner, N Selzner, G Therapondos and L B Lilly

Transplantation proceedings, Vol.45(6), pp.2288-2294

07/2013

DOI: 10.1016/j.transproceed.2012.11.009

PMID: 23953540

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Abstract

Obesity is thought to be associated with higher rates of morbidity and mortality after liver transplantation (LT); however, its actual impact is difficult to evaluate, in part because of the confounding effects of fluid accumulation on body mass index (BMI). We sought to define the effects of conventional BMI (cBMI) and modified BMI (mBMI; calculated by multiplying the BMI by serum albumin level to compensate for fluid accumulation), on the outcome of LT recipients overall. A cohort of 507 patients who underwent LT from April 2000 to August 2006 were analyzed. Pre-LT diabetes mellitus was seen somewhat more frequently in the higher mBMI group (P = .054), whereas there was no difference across cBMI categories. The recipients at extremes of cBMI (>40 kg/m(2) and <18.5 kg/m(2)) had significantly lower patient and graft survival than other groups (P = .038 and P = .010, respectively); however, no statistically significant differences were found in overall patient and graft survival across mBMI categories. There were no differences in duration of intensive care unit stay, duration of overall hospital stay, and vascular complications after LT among mBMI categories. Pre-LT obesity alone, when estimated by mBMI rather than by cBMI, should not be a contraindication for LT.

Multivariate Analysis

Predictive Value of Tests

Humans

Middle Aged

Male

Postoperative Complications - mortality

Obesity - blood

Serum Albumin, Human

Contraindications

Patient Selection

Time Factors

Adult

Female

Obesity - diagnosis

Retrospective Studies

Obesity - mortality

Body Mass Index

Length of Stay

Risk Assessment

Obesity - complications

Risk Factors

Kaplan-Meier Estimate

Proportional Hazards Models

Graft Survival

Liver Transplantation - mortality

Treatment Outcome

Biomarkers - blood

Serum Albumin - analysis

Ontario

Details

Title: Subtitle: The impact of obesity as determined by modified body mass index on long-term outcome after liver transplantation: Canadian single-center experience
Creators: T Tanaka - Multi-Organ Transplant Program/Liver Transplant Unit, University Health Network/Toronto General Hospital, Toronto, Ontario, Canada
E L Renner
N Selzner
G Therapondos
L B Lilly
Resource Type: Journal article
Publication Details: Transplantation proceedings, Vol.45(6), pp.2288-2294
DOI: 10.1016/j.transproceed.2012.11.009
PMID: 23953540
ISSN: 0041-1345
eISSN: 1873-2623
Language: English
Date published: 07/2013
Academic Unit: Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9984094553202771

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