Outcomes of living donor liver transplant in elevated body mass index over a decade in the United States - 13/04/25
, Matthew Byrne a, Xueya Cai b, Shan Gao b, John Martens a, Luis I Ruffolo a, Ana Paula Cupertino a, c, Karen Pineda-Solis a
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Highlights |
• | Recipient obesity is not associated with worse graft survival. |
• | Recipient obesity is not associated with higher rates of death. |
• | An obesity paradox may be at play in living donor liver transplant. |
• | Patients of all sizes should be considered for living donor liver transplant. |
Abstract |
Introduction |
Living donor liver transplant (LDLT) is a treatment option for end stage liver disease (ESLD). This study assesses the impact of recipient BMI on LDLT outcomes.
Methods |
The United Network for Organ Sharing (UNOS) database was reviewed for adult LDLTs between January 2010 and December 2020. Recipients were stratified by BMI: Normal: < 25 kg/m2; Overweight: 25 to <30 kg/m2, Class 1 Obesity: 30 to <35 kg/m2, and Class 2/3 Obesity: ≥35 kg/m2. Recipient and donor characteristics, and post-transplant graft failure and mortality were compared.
Results |
3068 patients were included. The mean age was 53 ± 13 years. The prevalence of diabetes and MASH cirrhosis was positively correlated with higher BMI groups (p < 0.0001 and p < 0.0001). At 5-years, graft failure (GF) in each group was 7.7 %, 5.2 %, 4.2 %, and 3.5 %, respectively (p = 0.0091). At 5 years, rate of death in each group was 11.2 %, 12.5 %, 10.7 %, and 10.4 %, respectively (p = 0.61). After controlling for patient demographics, clinical characteristics, and donor age, weight was no longer associated with graft failure or death.
Conclusion |
In this retrospective analysis, recipient BMI did not correlate with death, and obesity is associated with lower rates of graft failure. Obesity alone should not preclude candidacy for LDLT.
Le texte complet de cet article est disponible en PDF.Keywords : Living donor liver transplant, Obesity, BMI, Health disparities
Abbreviations : Body mass index, Cold ischemia time, Deceased donor liver transplant, End stage liver disease, Graft to recipient weight ratio, Graft failure, Hepatitis C Virus, Hepatocellular carcinoma, Interquartile range, Length of stay, Living donor liver transplant, Metabolic Dysfunction Associated Steatohepatitis, Model for End Stage Liver Disease, Small for size syndrome, Standard liver volume, Standard Transplant Analysis and Research, United Network for Organ Sharing, United States
Plan
Vol 18
Article 100274- mai 2025 Retour au numéro
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