Underweight BMI Is Associated with Graft Failure and Increased Mortality in Liver Transplant Recipients.
1Renal Division, Department of Internal Medicine, Washington University in St. Louis, St. Louis
2 Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis
3Division of Biostatistics, Washington University in St. Louis, St. Louis
4Department of Surgery, Washington University in St. Louis, St. Louis.
Meeting: 2016 American Transplant Congress
Abstract number: B250
Keywords: Allocation and Donor Issues (DCD/ECD), Poster Session B: Liver: MELD
Session Information
Date: Sunday, June 12, 2016
Session Name: Poster Session B: Liver: MELD, Allocation and Donor Issues (DCD/ECD)
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background:
Malnutrition and sarcopenia have been associated with inferior outcomes after liver transplantation. However, little is known about the differential impact of underweight on outcomes based on recipient calculated Model of End Stage Liver Disease (MELD) score.
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 Cox regression, we examined the association between underweight and patient death, graft failure, and death-censored graft failure, controlling for donor and recipient demographics and characteristics.
Results:
Compared to normal weight recipients, underweight recipients were independently associated with patient death [adjusted hazard ratio (aHR) 1.15, p-value (P) <0.01], graft failure (aHR 1.12, P=0.02), and death-censored graft failure (aHR 1.15, P=0.009). In the low MELD score group (≤10), underweight was associated with increased mortality (aHR 1.44, P=0.025) compared to normal weight recipients. However, in the higher MELD score categories (11-18), (19-24), and (≥25), underweight was not a significant risk factor for patient death (aHR 1.26, P=0.072, aHR 1.04, P= 0.81, and aHR 1.07, P=0.6, respectively).
Conclusion:
Overall, Underweight BMI is associated with increased mortality and graft failure after transplantation. The association of underweight and increased mortality is evident in the low MELD score recipients. Higher MELD score recipients have a higher risk of death, which might mask the impact of underweight for these individuals.
CITATION INFORMATION: Alhamad T, Carlsson N, Liu X, Wellen J, Garonzik-Wang J, Chang S.-H. Underweight BMI Is Associated with Graft Failure and Increased Mortality in Liver Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Alhamad T, Carlsson N, Liu X, Wellen J, Garonzik-Wang J, Chang S-H. Underweight BMI Is Associated with Graft Failure and Increased Mortality in Liver Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/underweight-bmi-is-associated-with-graft-failure-and-increased-mortality-in-liver-transplant-recipients/. Accessed February 16, 2020.« Back to 2016 American Transplant Congress