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:6/26/2016)... (PRWEB) , ... June 26, 2016 , ... PawPaws ... a new product that was developed to enhance the health of felines. The formula ... , The two main herbs in the PawPaws Cat Kidney Support Supplement ...
(Date:6/25/2016)... ... ... of Bruton Memorial Library on June 21 due to a possible lice infestation, as reported ... head lice: the parasite’s ability to live away from a human host, and to infest ... in the event that lice have simply gotten out of control. , As lice are ...
(Date:6/25/2016)... ... ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health ... of their exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards ... at the BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... Marcy was in a crisis. Her son ... lash out at his family verbally and physically. , “When something upset him, he couldn’t ... would use it. He would throw rocks at my other children and say he was ...
(Date:6/24/2016)... ... ... makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business for a Fair Minimum ... by 2020 and then adjusting it yearly to increase at the same rate as the ... wage floor does not erode again, and make future increases more predictable. , The company ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 ... "Pharmaceutical Excipients Market by Type (Organic Chemical (Sugar, ... Formulation (Oral, Topical, Coating, Parenteral) - Global Forecast to ... The global pharmaceutical excipients market ... at a CAGR of 6.1% in the forecast period ...
(Date:6/23/2016)... , June 23, 2016 Research ... Pharma News Issue 52" report to their offering. ... in influenza treatment creates a favourable commercial environment for MedImmune ... growing patient base that will serve to drive considerable growth ... vaccine would serve to cap sales considerably, but development is ...
(Date:6/23/2016)... Revolutionary technology includes multi-speaker listening ... industry leaders in advanced audiology and hearing aid technology, ... ™, the world,s first internet connected hearing aid that ...      (Photo: http://photos.prnewswire.com/prnh/20160622/382240 ) , ... ,world firsts,: , TwinLink™ - the first ...
Breaking Medicine Technology: