Impact of body mass index on graft failure and overall survival following liver transplant.
OBJECTIVE
To assess the influence of body mass index (BMI) in the outcome of liver transplantation.


BACKGROUND
Body mass index appears to affect liver transplantation, independently of several risk factors.


METHODS
A review of the United Network for Organ Sharing database included 32 515 liver transplants from 1992 through 2000 with at least one follow-up visit, of which 26 920 had information for determining BMI. The overall impact of elevated BMI (>25), and the impact of increasingly elevated BMI (25-40+) on graft failure rates and overall survival rates are assessed using proportional hazards regression.


RESULTS
Controlling for follow-up time, age, gender, race, number of comorbidities, and status 1 designation, the impact of BMI on survival was mixed. The risk of death was elevated for patients with low BMI (<19) and BMI values of >/=40. Compared with patients with BMI of 19-22, those with BMI > 25 had a decreased likelihood of death. This decrease was seen among patients with BMI of 25-34.


CONCLUSIONS
BMI did not significantly affect rates of graft failure. Compared with patients with a BMI in the 'normal' range, those with moderately elevated BMI had decreased likelihood of death while patients with low BMI or extremely high BMI had increased likelihood of death.
Rustgi
Vinod K
VK
Department of Transplant Surgery, Georgetown University Medical Center, Fairfax, VA 22031, USA. hepgi@aol.com
Marino
Gustavo
G
Rustgi
Sheila
S
Halpern
Michael T
MT
Johnson
Lynt B
LB
Tolleris
Christine
C
Taddei
Tamar H
TH
D015992:Body Mass Index; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000453:epidemiology*; D051437:Renal Insufficiency / Q000453:epidemiology*; D012307:Risk Factors