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Tipping the Scales: Liver Transplant Outcomes of the Super Obese

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Journal of Gastrointestinal Surgery

Abstract

Objective

We aim to study outcomes in liver transplant recipients with body mass index (BMI) ≥50 using the United Network for Organ Sharing (UNOS) database.

Methods

We reviewed patients undergoing liver transplantation recorded in the UNOS database from 1988 to 2013. Of 104,250 liver transplant procedures, 123 were performed on super obese patients.

Results

Sixty-four percent of the super obese patients are female (64 %) and had a mean age 47 years (20–71). The mean BMI was 53.5 (50–72.86) and 16 % had diabetes. The mean Model for End-Stage Disease (MELD) score at transplant was 29.1 (6–53). It was found that BMI ≥50 increased 1.6-fold the risk of death within 30 days after liver transplantation. Graft failure was increased by 52 % and overall mortality was by 62 %. A 1:1 propensity score-matched analysis demonstrated that patients with BMI <50 have significantly better graft and overall patient survival than the super obese.

Conclusions

Overall, our data shows that BMI ≥50 is an independent predictor of perioperative mortality and graft and overall patient survival. Further studies are necessary to better understand predictors of outcomes in super obese patients.

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Authorship

Substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work were performed by JA, XM, MD, MS, AG, JB, FM, and RG

Drafting the work or revising it critically for important intellectual content was performed by JA, XM, MD, MS, AG, JB, FM, and RG

Data was analyzed by XM.

Final approval of the version to be published was performed by JA, XM, MD, MS, AG, JB, FM, RG

Agreement to be accountable for all aspects of the work was agreed by JA, XM, MD, MS, AG, JB, FM, RG.

The final version was approved by all authors.

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Authors and Affiliations

  1. Department of Surgery, University of Kentucky College of Medicine Transplant Center, 800 Rose Street, C451, Lexington, KY, 40536-0293, USA

    Jose Alvarez, Xioanon Mei, Michael Daily, Malay Shah, Jonathan Berger, Francesc Marti & Roberto Gedaly

  2. Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Kentucky College of Medicine, Lexington, KY, USA

    Alla Grigorian

Authors
  1. Jose Alvarez
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  2. Xioanon Mei
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  3. Michael Daily
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  4. Malay Shah
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  5. Alla Grigorian
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  6. Jonathan Berger
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  7. Francesc Marti
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  8. Roberto Gedaly
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Corresponding author

Correspondence to Roberto Gedaly.

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Cite this article

Alvarez, J., Mei, X., Daily, M. et al. Tipping the Scales: Liver Transplant Outcomes of the Super Obese. J Gastrointest Surg 20, 1628–1635 (2016). https://doi.org/10.1007/s11605-016-3185-0

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  • DOI: https://doi.org/10.1007/s11605-016-3185-0

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