Navigation Links
Liver transplant offers survival benefits for patients of all sizes
Date:12/4/2007

Patients with high BMIs experience a significant survival benefit from liver transplantation and had similar rates of mortality after transplant compared to patients with normal BMI. Therefore, obesity alone should not keep patients from being listed for transplantation, say the authors of a study in the December issue of Liver Transplantation, a journal by John Wiley & Sons. The article is also available online via Wiley Interscience (http://www.interscience.wiley.com/journal/livertransplantation).

As the prevalence of obesity has increased in the United States, patients with end-stage liver diseasewho might be saved by a transplantare more likely to be obese. About 1 in 5 are morbidly obese, with a BMI over 40. Previous studies have shown that morbidly obese patients face higher risk of morbidity and mortality after liver transplantation, leading the American Association for the Study of Liver Diseases (AASLD) to recommend that morbid obesity should be considered a contraindication to the surgery. However, until now, no studies have considered the survival benefit for patients who receive a transplant compared to those who do not.

To determine how BMI influences the survival benefits from liver transplantation, researchers led by Shawn Pelletier, of the University of Michigan, conducted a retrospective study of all 25,647 adult patients listed for liver transplantation in the U.S. between September 1, 2001 and December 31, 2004. The patients were classified by BMI in the following way: underweight (BMI<20); non-obese (BMI 20<25); overweight (BMI 25<30); obese (BMI 30<35); severely obese (BMI 35<40) and morbidly obese (BMI>40). The researchers compared outcomes for patients within these groups after adjusting for age, gender, race, ascites status, diagnosis and Model of End-Stage Liver Disease (MELD) score.

Our study demonstrates a clear survival benefit for liver transplant recipients when compared to their counterparts on the waiting list, regardless of BMI, the authors report.

Furthermore, no group showed a significant difference in post-transplant mortality risk compared to the group with a normal BMI, in contrast to the findings of previous studies.

For candidates who remained on the waiting list throughout the study period, there was also no significant difference in mortality risk among the BMI groups, except for underweight patients, who were 61 percent more likely to die, compared to those with a normal BMI.

Our study found that obese patients, when compared to patients with normal BMI have a similar risk of death while on the liver transplant waiting list, have similar survival rates following liver transplantation, and have a similar reduction in the risk of death, say the authors, who suggest that the AASLD recommendation regarding morbidly obese patients be reconsidered.

Unlike previous studies, this study did not identify an increase in mortality for obese patients undergoing liver transplant, including morbidly obese patients. In contrast, underweight liver transplant recipients were identified to be at an increased risk of death. However, all categories of BMI demonstrated a significant survival benefit when compared to their counterparts on the waiting list. Therefore, BMI alone should not necessarily exclude patients with end-stage liver disease from access to liver transplantation, the authors conclude.

An accompanying editorial by Paul Thuluvuth confirms that it is clear from this study that morbidly obese patients benefited from liver transplantation. However, he says, the shortage of organs mandates that these precious resources be used in a more judicious manner.

Because many other studies indicate that obese patients do not fare as well after transplantation, and because morbid obesity is a surrogate marker of other serious co-morbidities like vascular disease, diabetes, hyperlipidemia, he concludes that morbidly obese patients with one or more other serious co-morbidities..should not be offered liver transplantation. This process will allow us to offer liver transplant in a selective manner to some morbidly obese patients, and thereby assuring a low morbidity and better long-term survival. That should be our goal, he says.


'/>"/>

Contact: Amy Molnar
amolnar@wiley.com
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Advanced Age No Bar to Liver Transplant
2. The American Liver Foundation Appoints Rick Smith, a Twenty-Year Veteran of The MS Society, as Chief Executive Officer
3. Researchers Find Better Way to Deliver Blood Thinner
4. Federal research plan to determine nanotech risks fails to deliver
5. Liver cancer marker could yield blood test for early detection
6. Blood Marker Might Help Spot Early Liver Cancer
7. Natural Protein Could Help Spot, Treat Liver Cancer
8. Diet Change Can Curb Fatty Liver Disease
9. US FDA Fast Tracks PI-88 for the Treatment of Post Resection Liver Cancer
10. Re-plumbing liver helps beat cancer
11. Free Prescription Drug Program Uses Internet to Deliver Cards - Offers Assistance to Uninsured
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/24/2017)... ... August 24, 2017 , ... Lori ... the development and advances in Desensitization therapy to improve the outcomes of organ ... about his remarkable journey of his 25 years of research in developing therapies ...
(Date:8/24/2017)... ... August 24, 2017 , ... Prime candidates for home ... have a condition that needs further monitoring such as surgery, stroke, heart attack ... stable, such as diabetes, high blood pressure, heart/lung disease, arthritis and stroke. ...
(Date:8/23/2017)... ... 2017 , ... The Arc Mercer, Capitol County’s premier provider of programs and ... community organization for people with special needs. The group, the Special Needs Alliance for ... of New Jersey – but the first in the entire country! , SNAP was ...
(Date:8/23/2017)... ... 2017 , ... Drs. Steven White and Brad Haines are pleased to announce ... of this offer, valued at more than $300 per year, new patients can enjoy ... patients receive a complimentary professional whitening procedure. , Stained or yellowed tooth enamel ...
(Date:8/23/2017)... ... ... Awards have announced the winners of the Best of the IBA Awards in The 2017 ... in the 2017 IBAs were not able to apply for the Best of the IBA ... awards won in the IBAs with a Gold Stevie win counting for three points, a ...
Breaking Medicine News(10 mins):
(Date:8/15/2017)... 2017   Mostyn Law and Gulf Coast Regional Blood ... . The Mostyn Law family has had 3 ... is why Mostyn Law is partnering with Gulf Coast ... its appreciation. Blood supplies are running low. Gulf Coast ... hospital needs in August. That is why the blood center reached ...
(Date:8/15/2017)... , Aug. 15, 2017  AOTI Inc. announced today that ... Therapy Inc., has recently opened a New York City Office in ... usage of its unique Topical Wound Oxygen (TWO 2 ) homecare ... the Accreditation Commission for Health Care (ACHC) under the company,s DMEPOS ... ...
(Date:8/8/2017)... -- BioLineRx Ltd. (NASDAQ/TASE: BLRX), a clinical-stage biopharmaceutical company focused ... for the second quarter ended June 30, 2017. ... and to date: ... Company,s lead project, BL-8040: Announced plans ... novel stem cell mobilization treatment for autologous bone-marrow transplantation ...
Breaking Medicine Technology: