Does BMI Affect Survival in Cadaveric Liver Transplantation for Benign Conditions?

S. Ayloo, S. Hurton, M. Cwinn, R. Kavanagh, M. Molinari.

Surgery, Dalhousie University, Halifax, NS, Canada.

Meeting: 2015 American Transplant Congress

Abstract number: C128

Keywords: Liver transplantation, Obesity, Survival

Session Information

Session Name: Poster Session C: Liver Donation and Allocation

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Obesity is a relative contraindication to liver transplantation (LT). Aim of this study was to analyze morbidity, mortality, long-term survival of cadaveric LTs stratified by BMI using SRTS data

Methods Adult recipients of LT for benign conditions (April 1994-June 2013) were included. BMIs were categorized by WHO classification. Two-tailed P values less than 0.05 were considered significant

Results Patients characteristics are reported in table 1. 30day mortality occurred in 11.5% of underweight patients, 10% in normal weight, 10.2% in overweight, 11.5% in class I, 13% in class II, 16.3% in class III obese patients and in 16.3% of recipients with BMI>45 (P=0.0001). Unadjusted survival revealed that normal weight patients (median survival 176 months;95% CI 170.5-181.4) had better survival in comparison to underweight patients (145months;P=0.0001), class II obese (157months;P=0.04), class III (153months;P=0.03) and patients with BMI>45 (133months;P=0.01). Survival analysis showed a significant improvement for all BMI classes transplanted after 2002 except for underweight patients (P=0.016)(Figure 1)

Conclusions Obesity is not a predictor for inferior survival in LT recipients transplanted after 2002. On the other hand, underweight status remains a significant risk factor for perioperative mortality and lowere 5-year survival

Table 1. Clinical and Socio-demographic Characteristics of the Study Population (Total n. 51,883 Patients)
Variable	Frequency, Mean	SD, (%)
Age, years (Mean, SD)	51.8	10,3
Gender, Males (N, %)	32,531	62,7
Primary Cause of Liver Failure (N, %)
Alcohol	8,662	16.70%
HCV	13,996	27.00%
PBC	2,562	4.90%
PSC	1,292	2.50%
NASH	2,516	4.80%
Cryptogenic	3,158	6.10%
Autoimmune	1,893	3.50%
BMI (Mean, SD)	28	5.7
Underweight (BMI<18.5)	1,094	2.10%
Normal Weight (BMI 18.5-24.99)	15,809	30.50%
Overweight (BMI>25)	17,865	34.40%
Obesity Class I (BMI 30-34.99)	10,592	20.40%
Obesity Class II (BMI 35-39.99)	4,695	9.00%
Obesity Class III (BMI>40)	1,828	3.50%
Patients with BMI>45	289	0.60%
MELD score	24.7	9.7

BMI= Body Mass Index; HCV=Hepatitis C Virus; PBC=Primary Biliary Cirrhosis; PSC=Primary Sclerosing Cholangitis; NASH=Non-Alcoholic Steato-Hepatitis; MELD=Model for End-Stage Liver Disease

To cite this abstract in AMA style:

Ayloo S, Hurton S, Cwinn M, Kavanagh R, Molinari M. Does BMI Affect Survival in Cadaveric Liver Transplantation for Benign Conditions? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/does-bmi-affect-survival-in-cadaveric-liver-transplantation-for-benign-conditions/. Accessed November 23, 2024.

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