• hepatic;
  • influence;
  • obesity;
  • transplantation

Abstract:  Goals:  To assess the influence of body mass index (BMI) in the outcome of liver transplantation.

Background:  Body mass index appears to affect liver transplantation, independently of several risk factors.

Study:  A review of the United Network for Organ Sharing database included 32 515 liver transplants from 1992 through 2000 with at least one follow-up visit, of which 26 920 had information for determining BMI. The overall impact of elevated BMI (>25), and the impact of increasingly elevated BMI (25–40+) on graft failure rates and overall survival rates are assessed using proportional hazards regression.

Results:  Controlling for follow-up time, age, gender, race, number of comorbidities, and status 1 designation, the impact of BMI on survival was mixed. The risk of death was elevated for patients with low BMI (<19) and BMI values of ≥40. Compared with patients with BMI of 19–22, those with BMI > 25 had a decreased likelihood of death. This decrease was seen among patients with BMI of 25–34.

Conclusion:  BMI did not significantly affect rates of graft failure. Compared with patients with a BMI in the ‘normal’ range, those with moderately elevated BMI had decreased likelihood of death while patients with low BMI or extremely high BMI had increased likelihood of death.