title: Obese and nonobese recipients had similar need for ventilatory support after liver transplantation.
abstract: BACKGROUND
  Obesity is a risk factor for patients undergoing major surgery. In liver transplantation, the morbidity and mortality in these patients may be higher owing to concomitant diseases that may prolong hospital stay. Moreover, the restrictive respiratory pattern in these patients, associated with pulmonary complications related to liver disease can impact the postoperative recovery. We sought to analyze the impact of high body mass index (BMI) on hospital and intensive care unit (ICU) stay, necessity and length of use either invasive and noninvasive ventilatory support in the early postoperative period after liver transplantation.
  
  
  METHODS
  Between January 2007 and March 2009, we performed 85 liver transplantations in adult patients. BMI was calculated on the day of the transplantation. Data from 136 recipients undergoing OLT were reviewed by age, gender, etiology of liver disease, Model for End-Stage Liver Disease score, Child-Pugh class, cold and warm ischemic times, ICU stay, duration of invasive mechanical, and use of noninvasive ventilation (NIV). We divided the patients into 3 groups: Group 1, (normal weight BMI 18.5-24.99), versus group 2 overweight--BMI 25-29.99; versus group 3, obese--BMI ≥30.
  
  
  RESULTS
  Groups 1, 2, and 3 had similar lengths of stay in the ICU, necessity of NIV as well as 6 month, 1- and 2-year survivals (P > .05).
  
  
  CONCLUSIONS
  High BMI patients showed similar results to normal or overweight patients. Obesity should not be contraindication to liver transplantation.
authors.affiliation: Programa Integrado de Transplante, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Werneck
authors.forename: R C
authors.initials: RC
authors.lastname: Afonso
authors.forename: G R
authors.initials: GR
authors.lastname: Coelho
authors.forename: C
authors.initials: C
authors.lastname: Sboarini
authors.forename: M P V
authors.initials: MP
authors.lastname: Coelho
authors.forename: T
authors.initials: T
authors.lastname: Thomé
authors.forename: L F
authors.initials: LF
authors.lastname: Lisboa
authors.forename: B H
authors.initials: BH
authors.lastname: Ferraz Neto
mesh_terms: D015992:Body Mass Index; D016022:Case-Control Studies; D006301:Health Services Needs and Demand; D006801:Humans; D007362:Intensive Care Units; D016031:Liver Transplantation; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D012121:Respiration, Artificial