The Role of Obesity in Survival Outcomes of Liver Transplant Recipients with High MELD Score.
1Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis
2Division of Biostatistics, Washington University in St. Louis, St. Louis
3Department of Surgery, Washington University in St. Louis, St. Louis
4Department of Pharmacy, Barnes Jewish Hospital, St. Louis
5Renal Division, Washington University, St. Louis.
Meeting: 2016 American Transplant Congress
Abstract number: B259
Keywords: Graft failure, Liver, Obesity
Session Information
Session Name: Poster Session B: Liver: MELD, Allocation and Donor Issues (DCD/ECD)
Session Type: Poster Session
Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background:
Obesity has become an epidemic in the United States. More than one third of adults are obese, defined as having body mass index (BMI) greater than or equal to 30 kg/m[sup2]. Patterns of obesity in liver transplant recipients mirror the high prevalence of obesity in the general population. The impact of obesity on survival outcomes in patients with high Model of End Stage Liver Disease (MELD) scores has not been well examined.
Methods:
We performed a retrospective analysis using the Organ Procurement and Transplantation Network (OPTN) database and examined donation after brain death liver transplant recipients between 2000 and 2013. Based on recipient BMI, we categorized recipients into underweight: BMI <18.5 (n=1,120); normal weight: BMI 18.5-25 (n=19,167); overweight: BMI 25-30 (n=23,907); obese: BMI 30-35 (n=14,312); and severely obese: BMI >35 (n=8,462) kg/m[sup2]. Using a Cox model, we examined the association between obesity and patient death, controlling for donor and recipient demographics and characteristics.
Results:
Compared to normal weight recipients, obese recipients [adjusted hazard ratio (aHR) =0.9, p-value (P) <0.01] and severely obese recipients (aHR =0.95, P =0.02) were independently associated with a lower risk for patient death. Recipient BMI was not a risk factor for death-censored graft failure. In the high MELD score group (19-24), obesity and severe obesity were associated with a lower risk of patient death (aHR =0.89, P= 0.049 and aHR =0.86, P =0.034, respectively). In the very high MELD score group (≥25) recipient obesity and severe obesity were not associated with an increased risk of patient death (aHR =0.86, P =0.37 and aHR =0.95, P =0.34, respectively).
Conclusion:
In general, obesity and severe obesity in liver transplant recipients are associated with a lower risk of mortality. Regardless of MELD score category, obesity and severe obesity are not associated with a higher risk of patient death.
CITATION INFORMATION: Chang S.-H, Carlsson N, Liu X, Wellen J, Hagopian J, Horwedel T, Alhamad T. The Role of Obesity in Survival Outcomes of Liver Transplant Recipients with High MELD Score. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Chang S-H, Carlsson N, Liu X, Wellen J, Hagopian J, Horwedel T, Alhamad T. The Role of Obesity in Survival Outcomes of Liver Transplant Recipients with High MELD Score. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-role-of-obesity-in-survival-outcomes-of-liver-transplant-recipients-with-high-meld-score/. Accessed May 21, 2025.« Back to 2016 American Transplant Congress