title: Impact of recipient morbid obesity on outcomes after liver transplantation.
abstract: The aim of this study was to analyze the impact of morbid obesity in recipients on peritransplant resource utilization and survival outcomes. Using a linkage between the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases, we identified 12 445 patients who underwent liver transplantation (LT) between 2007 and 2011 and divided them into two cohorts based on recipient body mass index (BMI; <40 vs. ≥40 kg/m²). Recipients with BMI ≥40 comprised 3.3% (n = 416) of all LTs in the studied population. There were no significant differences in donor characteristics between two groups. Recipients with BMI ≥40 were significant for being female, diabetic, and with NASH cirrhosis. Patients with a BMI ≥40 had a higher median MELD score, limited physical capacity, and were more likely to be hospitalized at LT. BMI ≥40 recipients had higher post-LT length of stay and were less often discharged to home. With a median follow-up of 2 years, patient and graft survival were equivalent between the two groups. In conclusion, morbidly obese LT recipients appear sicker at time of LT with an increase in resource utilization but have similar short-term outcomes.
authors.affiliation: Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, OH, USA.
authors.forename: Ashish
authors.initials: A
authors.lastname: Singhal
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Wilson
authors.forename: Koffi
authors.initials: K
authors.lastname: Wima
authors.forename: R Cutler
authors.initials: RC
authors.lastname: Quillin
authors.forename: Madison
authors.initials: M
authors.lastname: Cuffy
authors.forename: Nadeem
authors.initials: N
authors.lastname: Anwar
authors.forename: Tiffany E
authors.initials: TE
authors.lastname: Kaiser
authors.forename: Flavio
authors.initials: F
authors.lastname: Paterno
authors.forename: Tayyab S
authors.initials: TS
authors.lastname: Diwan
authors.forename: E Steve
authors.initials: ES
authors.lastname: Woodle
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Abbott
authors.forename: Shimul A
authors.initials: SA
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome
keywords: Scientific Registry of Transplant Recipients; University HealthSystem Consortium; body mass index; liver; obesity; survival; transplantation