Obesity does not significantly impact outcomes following simultaneous liver kidney transplantation: review of the UNOS database - a retrospective study

Transplant International : Official Journal of the European Society for Organ Transplantation
Jonathan W YuTrevor W Reichman

Abstract

Simultaneous liver kidney transplantation (SLK) is the only curative option for patients with combined end stage liver and kidney disease. With the global obesity epidemic, an increasing number of obese patients are in need of SLK. However, the impact of pre-transplant obesity on outcomes after SLK is unknown. An analysis of the United States OPTN registry (Oct 1987 - June 2016) identified 7205 SLK transplants. Of these, 1677 patients were overweight/obese (OW, BMI 30-39) and 183 were morbidly obese (MO, BMI ≥40). 29% of patients had NASH in the MO group versus 16.4% and 4.7% in the OW and normal weight (NW) groups, respectively. The 1, 3 and 5 year overall patient survival, kidney and liver graft survivals were comparable between the three groups. Numerically higher rates of acute kidney rejection were reported in the MO group at 1 year [12.73%, 8.59%, and 10.05% for MO, OW and NW, respectively (P = 0.22)]. Multivariate analysis identified diagnosis of hepatitis C, donor age, diabetes mellitus, and delayed kidney transplant function but not BMI as risk factors for poor patient and both liver and kidney graft survival. Based on these findings, obesity should not be a contraindication for SLK even for patients with BMIs ≥ 40.

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Citations

Sep 11, 2020·Transplantation·Tommy IvanicsGonzalo Sapisochin
Jul 27, 2021·Clinics and Research in Hepatology and Gastroenterology·François VilleretDomitille Erard-Poinsot

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