In the Journals

Obese patients with diabetes face higher liver transplant morbidity

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February 3, 2014

Morbidity after liver transplantation increased among obese patients with diabetes, according to researchers.

“There is much evidence on post-transplant obesity and metabolic syndrome. However, the impact of pre-transplant obesity, hypertension and coronary artery disease on post-transplant outcomes has received less attention and is the focus of our study,” Adam S. J. R. Bartlett, MBChB, PhD, FRACS, of the New Zealand Liver Transplant Unit at Auckland City Hospital, said in a press release.

Bartlett and colleagues conducted a single-center, retrospective analysis of outcomes in 202 consecutive patients (mean age, 51 years; 67% men) who underwent liver transplantation from 2000 to 2010.

According to data, 4% patients were underweight, 27% were normal weight, 26% were overweight, 28% were obese, 9% were severely obese and 6% were morbidly obese.

BMI and body fat percentages were similar in 86% of the cohort and continued across calculated Model for End-Stage Liver Disease scores, according to data.

The researchers found that obesity was an independent risk factor for diabetes (P<.001) and post-transplant complications (P<.001). Obese patients with diabetes had the greatest risk for postoperative complications (P<.001) and longer hospital stays (5.81 days; P<.01), according to data.

Independent metabolic risk factors such as obesity, diabetes, hypertension and coronary artery disease did not have a significant effect on 30-day, 1- or 5-year patient survival.

“Our study confirms that BMI is an appropriate measure of body fat, and obesity alone should not prevent patients from receiving liver transplants,” Bartlett said in the press release. “Identifying modifiable risk factors during the pre-transplant assessment allows for earlier interventions, including weight control, diabetes management and coronary interventions such as stenting, all which may improve long-term outcomes following liver transplantation.”

Disclosure: The researchers report no relevant financial disclosures.

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