title: Complications Associated With Liver Transplantation in Recipients With Body Mass Index >35 kg/m(2): Would It Be a Poor Prognosis Predictive Factor?
abstract: BACKGROUND
  Obesity is a global epidemic that continues to increase in a great number of countries, and it has become a major public health problem in Spain. Unfortunately, the impact of obesity on survival in liver transplantation (LT) recipients is underestimated and controversial. The aim of this study was to determine if obesity is a risk factor for morbidity and mortality after LT.
  
  
  METHODS
  In a retrospective cohort study of the records of 180 consecutive patients who had undergone to LT from 2007 to 2013, 11 obese patients with body mass index (BMI) >35 kg/m(2) were identified. Their data have been compared with recipients with BMI 20-25 kg/m(2).
  
  
  RESULTS
  There were no differences in demographic data, Child-Pugh score, Model for End-Stage Liver Disease score, or cause of liver failure. BMI >35 kg/m(2) recipients had a significantly higher rate of portal vein thrombosis before LT, compared with the BMI 20-25 kg/m(2) group (36.5% vs 13.9%; P = .041). There were also no differences in development of post-reperfusion syndrome. The groups were also comparable concerning morbidity rate after LT, stay in the intensive care unit, and global hospital stay. However, the mortality rate was significantly higher in the obese group compared with the nonobese group (72.7% vs 38.9%; P = .032).
  
  
  CONCLUSIONS
  The results of the study clearly demonstrate higher mortality rates in obese patients undergoing LT; thus, it is fair to consider obesity as a poor prognosis predictive factor concerning mortality rate.
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain. Electronic address: j-triguero@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Triguero
authors.affiliation: Biostatistical and Epidemiological Support Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Molina
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: C
authors.initials: C
authors.lastname: San Miguel
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Notario
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Villegas
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Becerra
authors.affiliation: Biostatistical and Epidemiological Support Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Expósito
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: K
authors.initials: K
authors.lastname: Muffak
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Álvarez
authors.affiliation: General, Digestive Surgery, and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: Y
authors.initials: Y
authors.lastname: Fundora
mesh_terms: D000328:Adult; D015992:Body Mass Index; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain