Key result
Class III obesity (present in 1.1% of 2,024 patients) was not associated with a significant difference in patient and graft survival at 10-year follow-up after liver transplantation.
Why the study?
Studies have reported conflicting results regarding the impact of obesity on liver transplantation outcomes, amidst a dramatic increase in obesity.
Does class III obesity impact patient and graft survival or post-transplant weight gain in adult liver transplant recipients?
Cohort (n=2,024)
No
Does class III obesity impact patient and graft survival or post-transplant weight gain in adult liver transplant recipients?
Class III obesity is not associated with higher mortality after liver transplantation, suggesting it should not be considered an absolute contraindication, though significant post-transplant weight gain requires intervention.
Class III obesity does not appear linked to worse LT survival; supports expanding access but leaves open need for post-LT weight interventions in prospective studies.
BACKGROUND: There has been a dramatic increase in obesity in the United States. Several studies have reported conflicting results for the impact of obesity on outcomes of liver transplantation (LT). This study aims to assess the impact of obesity on LT and changes in body mass index (BMI) after transplantation. METHODS: All adult LTs performed at Indiana University between 2001 and 2018 were reviewed. BMIs of recipients were subdivided into 6 categories. Survival outcomes were compared across the subgroup. BMI was followed up in a cohort of patients from 2008 to 2018. RESULTS: Among 2024 patients, 25% were in class I obesity, 9.3% were in class II obesity, and 1.1% were in class III obesity. There was no significant difference in patient and graft survival at 10-y follow-up with respect to BMI. Among 1004 patients in the subgroup, BMI of all groups except the underweight group declined in the first 3 mo postoperatively; however, the BMI of all groups except the class III obesity group returned to the pre-LT level by 2 y and reached a plateau by 5 y. In the class III obesity group, there was a significant increase in body weight at 5 y. CONCLUSIONS: Class III obesity was not associated with higher mortality in our cohort. Because our cohort is small, it may be underpowered to detect a smaller difference in outcome. From our observation, obesity should not be considered a contraindication for LT. Post-LT interventions are required to prevent significant weight gain for the class III obesity group.
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Soma et al. (2022) conducted a cohort in Liver transplantation (n=2,024). Class III obesity vs. Other BMI categories was evaluated on Patient and graft survival at 10-year follow-up. Class III obesity (present in 1.1% of 2,024 patients) was not associated with a significant difference in patient and graft survival at 10-year follow-up after liver transplantation.
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