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

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