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

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

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