title: Body mass index in lung transplant candidates: a contra-indication to transplant or not?
abstract: BACKGROUND
  According to International Society of Heart and Lung Transplantation criteria, high body mass index (BMI; ≥ 30 kg/m(2)) is a relative contraindication for lung transplantation (LT). On the other hand, low BMI may be associated with worse outcome. We investigated the influence of pre-LT BMI on survival after LT in a single-center study.
  
  
  METHODS
  Patients were divided according to the World Health Organization criteria into 4 groups: BMI <18.5 kg/m(2) (underweight), BMI 18.5-24.9 kg/m(2) (normal weight), BMI 25-29.9 kg/m(2) (overweight), and BMI ≥ 30 kg/m(2) (obesity). An additional analysis was made per underlying disease.
  
  
  RESULTS
  BMI was determined in a cohort of 546 LT recipients, of which 28% had BMI <18.5 kg/m(2). Underweight resulted in similar survival (P = .28) compared with the normal weight group. Significantly higher mortality was found in overweight (P = .016) and obese patients (P = .031) compared with the normal-weight group. Subanalysis of either underweight (P = .19) or obese COPD patients (P = .50) did not reveal worse survival. In patients with interstitial lung disease, obesity was associated with increased mortality (P = .031) compared with the normal-weight group. In cystic fibrosis patients, underweight was not associated with a higher mortality rate (P = .12) compared with the normal-weight group.
  
  
  CONCLUSIONS
  Low pre-LT BMI did not influence survival rate in our cohort, independently from underlying disease.
authors.affiliation: Lung Transplant Unit, Lab of Pneumology, Katholieke Universiteit Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Ruttens
authors.affiliation: Lung Transplant Unit, Lab of Pneumology, Katholieke Universiteit Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium.
authors.forename: S E
authors.initials: SE
authors.lastname: Verleden
authors.affiliation: Lung Transplant Unit, Lab of Pneumology, Katholieke Universiteit Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Vandermeulen
authors.affiliation: Lung Transplant Unit, Lab of Pneumology, Katholieke Universiteit Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Vos
authors.affiliation: Lung Transplant Unit, Lab of Pneumology, Katholieke Universiteit Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium.
authors.forename: D E
authors.initials: DE
authors.lastname: van Raemdonck
authors.affiliation: Lung Transplant Unit, Lab of Pneumology, Katholieke Universiteit Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium.
authors.forename: B M
authors.initials: BM
authors.lastname: Vanaudenaerde
authors.affiliation: Lung Transplant Unit, Lab of Pneumology, Katholieke Universiteit Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium. Electronic address: geert.verleden@uzleuven.be.
authors.forename: G M
authors.initials: GM
authors.lastname: Verleden
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies