Telephone: 415-476-5892; FAX: 415-476-1343
Impact of the donor body mass index on the survival of pediatric liver transplant recipients and Post-transplant obesity†
Article first published online: 24 JUL 2012
Copyright © 2012 American Association for the Study of Liver Diseases
Volume 18, Issue 8, pages 930–939, August 2012
How to Cite
Perito, E. R., Rhee, S., Glidden, D., Paul Roberts, J. and Rosenthal, P. (2012), Impact of the donor body mass index on the survival of pediatric liver transplant recipients and Post-transplant obesity. Liver Transpl, 18: 930–939. doi: 10.1002/lt.23438
This project was supported by the National Institutes of Health through the National Center for Research Resources (grant UL1 RR024131 to the University of California San Francisco/Clinical and Translational Science Institute for United Network for Organ Sharing data), by the National Institutes of Health (grant T32 DK007762 to Emily Rothbaum Perito), and by the Health Resources and Services Administration (contract 234-2005-370011C for United Network for Organ Sharing data). The contents of this article are the responsibility of the authors alone and do not necessarily reflect the views or policies of the National Institutes of Health or the Department of Health and Human Services, nor does the mention of trades names, commercial products, or organizations imply endorsement by the US Government.
- Issue published online: 24 JUL 2012
- Article first published online: 24 JUL 2012
- Accepted manuscript online: 29 MAR 2012 06:12AM EST
- Manuscript Accepted: 22 MAR 2012
- Manuscript Received: 23 JAN 2012
In adult liver transplant recipients, the donor body mass index (dBMI) is associated with posttransplant obesity but not with graft or patient survival. Because of the obesity epidemic in the United States and the already limited supply of liver donors, clarifying whether the dBMI affects pediatric outcomes is important. United Network for Organ Sharing data for pediatric liver transplants in the United States (1990-2010) were evaluated. Data on transplants performed between 2004 and 2010 (n = 3788) were used for survival analyses with Kaplan-Meier and Cox proportional hazards models and for posttransplant obesity analyses with generalized estimating equations. For children receiving adult donor livers, a dBMI of 25 to <35 kg/m2 was not associated with graft or patient survival in univariate or multivariate analyses. A dBMI ≥ 35 kg/m2 increased the risk of graft loss [hazard ratio (HR) = 2.54, 95% confidence interval (CI) = 1.29-5.01, P = 0.007] and death (HR = 3.56, 95% CI = 1.64-7.72, P = 0.001). For pediatric donors, the dBMI was not associated with graft loss or mortality in a univariate or multivariate analysis. An overweight or obese donor was not a risk factor for posttransplant obesity. Overweight and obesity are common among liver transplant donors. This analysis suggests that for adult donors, a body mass index (BMI) of 25 to <35 kg/m2 should not by itself be a contraindication to liver donation. Severe obesity (BMI ≥ 35 kg/m2) in adult donors increased the risk of graft loss and mortality, even after adjustments for recipient, donor, and transplant risk factors. Posttransplant obesity was not associated with the dBMI in this analysis. Further research is needed to clarify the impact of donor obesity on pediatric liver transplant recipients. Liver Transpl, 2012. © 2012 AASLD.