Impact of body weight on long-term survival after lung transplantation.
OBJECTIVE
The purpose of this study was to determine the impact of a pretransplantation determination of body mass index (BMI) on survival after lung transplantation.


METHODS
Univariate and multivariate survival analyses of a single institution database consisting of 85 patients who had undergone lung transplantations between March 1994 and October 1998.


METHODS
University of Florida Health Science Center.


RESULTS
Kaplan-Meier survival curves showed that patients who were obese (ie, BMI, > or = 30) at a pretransplantation assessment had a marked decrease in posttransplantation survival time (log rank, p < 0.05; Wilcoxon, p < 0.05). The final Cox regression model revealed that the most powerful predictors of mortality after lung transplantation were higher pretransplantation BMI and the development of obliterative bronchiolitis.


CONCLUSIONS
Our results suggest that the posttransplantation risk for mortality is possibly three times greater for obese patients than for nonobese patients. Additional study is needed to identify the mechanisms for such higher risk in obese patients. Our data also suggest that transplantation centers should not routinely reject underweight patients (ie, BMI, < 18.5) or overweight patients (ie, BMI, 25 to 29.9) for lung transplantation listing solely on the basis of weight, as their outcomes may not be significantly different than patients with normal BMIs.
Kanasky
William F
WF
Department of Clinical and Health Psychology, University of Florida Health Science Center, Gainesville, FL 32610, USA.
Anton
Stephen D
SD
Rodrigue
James R
JR
Perri
Michael G
MG
Szwed
Thomas
T
Baz
Maher A
MA
D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D001989:Bronchiolitis Obliterans / Q000150:complications; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications; D016040:Lung Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome