title: Liver Transplantation and Donor Body Mass Index >30: Use or Refuse?
abstract: BACKGROUND
  Organ shortage is a major problem in liver transplantation. The use of extended criteria donors has become the most important strategy for increasing the donor pool. However, the role of donor body mass index has not yet been thoroughly investigated. The aim of our study was to compare outcomes after liver transplantation in patients who received a liver from a donor with a BMI <30, 30-39, and ≥40, with special regard to the incidence of early allograft dysfunction (EAD) and primary non-function (PNF).
  
  
  METHODS
  One hundred and sixty-three patients who underwent liver transplantation at the University Hospital Aachen between June 2010 and January 2014 were included in this analysis. The outcome of liver transplantation was evaluated by the 30-day and 1-year patient and graft survival rates and the incidences of post-reperfusion syndrome (PRS), EAD, and PNF.
  
  
  RESULTS
  The BMI 30-39 group had a higher incidence of EAD than the BMI <30 and BMI ≥40 groups. We observed 5 cases of PNF in the BMI <30 group. The incidence of acute renal failure was significantly higher in the BMI 30-39 and BMI ≥40 groups than in the BMI <30 group. Patient and graft survival did not differ significantly among the 3 groups.
  
  
  CONCLUSIONS
  Based on the findings of this study, grafts from obese donors with a BMI >30 can be safely transplanted. Therefore, the donor pool can be enlarged to include such obese donors without a negative impact on the long-term patient outcome after liver transplantation.
authors.affiliation: Department of General-, Viszeral- and Transplant Surgery, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Andert
authors.affiliation: General-, Viszeral- and Tramsplant Surgery, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Becker
authors.affiliation: General-, Viszeral- and Transplant Surgery, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Ulmer
authors.affiliation: General-, Viszeral- and Transplant Surgery, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Wenzel
authors.initials: W
authors.lastname: Schöning
authors.affiliation: Department of Anaesthesiology, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Hein
authors.affiliation: Department of Anaesthesiology, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Rimek
authors.affiliation: General-, Viszeral- and Tramsplant Surgery, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Neumann
authors.affiliation: General-, Viszeral- and Tramsplant Surgery, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schmeding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002648:Child; D046148:Donor Selection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D055031:Primary Graft Dysfunction / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D014019:Tissue Donors; D055815:Young Adult