Survival analysis of obese patients undergoing liver transplantation.
BACKGROUND
The influence of preoperative obesity in liver transplanted patients remains undetermined.


OBJECTIVE
To analyze the survival of obese patients undergoing liver transplantation.


METHODS
We calculated the body mass index (BMI; kg/m2) of 244 liver transplantation patients. All transplantations were performed from September 1991 to December 2006. The patients were divided according to the BMI values: nonobese (NO) patients (BMI<30) and obese (O) patients (BMI>30). Pre- and postoperative data were used. The following statistical tests were employed: Student's t test, Kaplan-Meier survival, and Cox-Mantel tests.


RESULTS
Group O was composed of 38 individuals (15.3%) with BMI of 33.1, and the BMI of NO was 24. Group O showed an average age of 50.1 years and group NO, 45.5 years (P<.05). Group O postoperative creatinine was higher (P=.001). Both groups had similar MELD scores with an average of 17.5+/-5.9. According to the Child-Pugh classification, group NO included 140 (69.6%) B and 61 (30.3%) C patients; group O, 8 (21%) B and 30 (79%) C patients. There were no significant differences between the groups when comparing cold and warm ischemia times, surgical times, intensive care stay, or blood requirements. The actuarial survivals after 1 and 5 years were 61.3% and 51% for group O and 68% and 47% for NO group (P>.05). A Cox proportional hazard analysis showed that the survival time in this study was related to red blood cell transfusions, recipient sodium, MELD score, donor sodium, and age. Recipient age was a main factor in multiple regression analysis for obese patients in this study.


CONCLUSIONS
There was no significant difference between O and NO for the 1-year and long-term survivals, but older patients displayed lower survival times.
Boin
I F S F
IF
Unit of Liver Transplantation, Faculty of Medical Science, Campinas, Brazil. ilkaboin@yahoo.com
Almeida
L V
LV
Udo
E Y
EY
Stucchi
R S B
RS
Cardoso
A R
AR
Caruy
C A
CA
Leonardi
M I
MI
Leonardi
L S
LS
D000328:Adult; D015992:Body Mass Index; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation / Q000401:mortality*; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data