Liver Transplantation Outcomes Similar for Obese and Lower Weight Patients

Obese patients are just as likely to benefit from liver transplantation and in fact are more likely to die while waiting on transplant lists than patients with lower BMI.

Centers that avoid liver transplants in morbidly obese patients may want to reconsider this practice, according to researchers presenting data at the American Association for the Study of Liver Diseases’ Liver Meeting.

Barry Schlansky, MD, MPH, C. Kristian Enestvedt, MD, and colleagues from Oregon Health and Science University used data from the U.S. national transplant database to investigate if morbidly obese patients fared worse than patients with a lower body mass index (BMI) following a liver transplant (LT).

The researchers followed patients from the “time of their transplant to death or graft loss, from wait listing to death before LT or receipt of LT, and from wait listing to death before or after LT (intention-to-treat).”

Their analysis noted that “3.9% of 80,221 waitlisted patients and 3.5% of 38,177 transplanted patients were morbidly obese,” and that survival rates after liver transplantation for morbidly obese patients have improved.

“Our study revealed that obese patients benefit more from liver transplantation than lower weight patients, and suggests that we should consider lowering weight restrictions for patients who are otherwise good candidates for liver transplant,” Dr Schlansky said in a press release about the study.

“Obesity brings unique challenges to liver transplantation, such as increased risks of diabetes, heart and kidney disease,” Dr Schlansky continued. “The liver transplant community will have to learn how to better deal with these issues if we begin transplanting more patients.

References:

1. Schlansky B, Naugler WE, Orloff SL et al. Liver transplant outcomes and survival benefit for obese patients in the United States: Are we disadvantaging the morbidly obese? Presented at: The Liver Meeting, American Association for the Study of Liver Diseases Nov. 13-17, 2015; San Francisco.