Body Composition and Overweight of Liver Transplant Recipients

Anastácio, Lucilene Rezende; Ferreira, Lívia Garcia; Ribeiro, Hélio; Lima, Agnaldo Soares; Vilela, Eduardo García; Correia, María Isabel Toulson Davisson

doi:10.1097/tp.0b013e31822e0bee

Cited by 46 publications

(36 citation statements)

References 26 publications

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“…(5–9) An analysis of a well-characterized multicenter LT database demonstrated that during the first and second year post-LT, mean weight gains were 6 kilograms (kg) and 3 kg, respectively. (6) Subsequent to 2-years post-LT, recipient weight did not change in a statistically or clinically significant manner.…”

Section: Introductionmentioning

confidence: 99%

Early weight changes after liver transplantation significantly impact patient and graft survival

Martinez‐Camacho¹,

Fortune

Gralla

et al. 2016

European Journal of Gastroenterology & Hepatology

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Background and Aim Associations between pre-liver transplantation (pre-LT) BMI and post-LT survival are well described; however, there are few data assessing associations between the commonly observed post-LT BMI changes and survival. We investigated the impact of early post-LT BMI change on post-LT patient and graft survival. Methods Using UNOS data, we identified 2,968 adult primary LT recipients who were not overweight pre-LT, BMI >16 to ≤25 kg/m2, and who had BMI recorded at 2-years post-LT. Delta BMI was defined as the BMI difference from pre-LT and 2-years post-LT. Recipients were grouped into three categories: BMI Gain (increase >1 BMI point), BMI Loss (decrease >1 BMI point), and BMI Stable (maintained BMI within 1 point). Associations between Delta BMI and patient and graft survival were evaluated using Kaplan Meier and multivariable Cox regression analyses. Results BMI Gain was common (54%) and associated with significantly greater 5-year patient and graft survival (90% and 89%, respectively), compared to recipients who had either BMI Loss (77% and 74%, respectively, p<0.0001 for both) or BMI Stable (83%, p=0.04 and 82%, p=0.007, respectively). In multivariable analyses, increasing Delta BMI was inversely associated with risk for death and graft loss (HR 0.89 [95% CI 0.86–0.91], p<0.001; and HR 0.88 [95% CI 0.86–0.91], p<0.001, respectively). Conclusion This study of a large national liver transplant database demonstrated that post-LT BMI gain was associated with better patient and graft survival, whereas BMI loss was associated with reduced patient and graft survival.

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Section: Introductionmentioning

confidence: 99%

Early weight changes after liver transplantation significantly impact patient and graft survival

Martinez‐Camacho¹,

Fortune

Gralla

et al. 2016

European Journal of Gastroenterology & Hepatology

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“…This is consistent with the theory of regain of the weight lost while waiting for transplantation. The highest incidence of obesity has also been observed in patients with a history of overweight or higher BMI prior to liver transplantation 8,22,24,25,31 . The use of immunosuppressive drugs as a risk factor for excess weight after liver transplantation is still controversial.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 90%

“…There are few data on food intake in liver transplant recipients. Nevertheless, none of the studies showed an association of dietary caloric intake with weight changes 8,10,11,25 . This is possibly due to the methods used, since intake is usually assessed at the time of data collection and not continuously.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…In a study with 143 patients undergoing liver transplantation with a median of four years since surgery, 58.1% were classified as having overweight by BMI and 69.9% by body composition. In the same study, 21% of individuals were classified as obese by BMI (e" 30 kg/m2) and 37.8% by body composition 25 . Although the prevalence of overweight and obesity are in clear ascendancy in recent years worldwide and in Brazil, yet the prevalence in the population undergoing transplantation is higher than in the general one.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…In the study by Anastácio et al 25 , 41.5% of the individuals were thus classified, and 88% had some degree of abdominal obesity (waist circumference greater than 80cm for women and 90cm for men) 25 . FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT AND OBESITY AND OBESITY AND OBESITY AND OBESITY AND OBESITY The factors described are often older age 8,29 , family history of overweight, high BMI prior to the disease 8,22,30 , post-transplant hypometabolism 8,10 , post-transplant physical inactivity 10 , high donor BMI 22 , being married 22,25 , few hours slept 25 and less dietary calcium intake 25 . Some authors demonstrated greater weight gain in patients undergoing liver transplantation for chronic liver diseases compared with those who were transplanted due to fulminant hepatic failure 8 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

See 2 more Smart Citations

Excesso de peso em pacientes submetidos ao transplante hepático

Anastácio

Angelis-Pereira

Vilela

et al. 2013

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTThis review aims to describe the incidence and prevalence of overweight and obesity after liver transplantation and the consequences associated with it. Literature review consultation was conducted in Medline / PubMed, SciELO, EMBASE and LILACS, with the combination of the following keywords: liver transplantation, overweight, obesity, weight gain. Overweight is incident on more than 60% of patients undergoing liver transplantation and obesity rates exceed 20% in the first year after surgery, during which occurs the largest relative weight gain. Studies have shown that between 60% and 70% of patients undergoing liver transplantation are overweight after the third year, 90% with abdominal obesity. Associated factors are, among others, advanced age, family history of overweight and excess weight prior to liver disease. The contribution of immunosuppressive medication remains controversial. Some of the consequences of overweight are liver steatosis, steatohepatitis, diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease and death.

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Energy Expenditure and Liver Transplantation: What We Know and Where We Are

Santos

Correia

Anastácio

2020

J Parenter Enteral Nutr

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Patients with end‐stage liver disease (ESLD) and undergoing liver transplantation (LTx) commonly present with malnutrition attributed to various etiologies. One of the causes is potential hypermetabolism resulting from increased resting energy expenditure (REE). After the surgery, it is hypothesized that these patients show a reduction in REE, which may contribute to the weight gain observed in this population. However, there have been controversial results regarding the metabolic status of ESLD patients and liver recipients, which has led us to critically review the pertinent literature. We enrolled studies with the following goals: assessment of REE of these patients either before or after surgery by using indirect calorimetry (measured REE [mREE]) and comparison of these mREE values with those of healthy controls or with REE values obtained using predictive equations (predicted REE [pREE]). For most patients, mREE and pREE values were comparable. However, ≥5.3% of patients exhibited hypermetabolism when the mREE was compared with the pREE using the Harris‐Benedict formula. Three follow‐up studies that were conducted postsurgery showed a progressive reduction in the mREE for ≤1 year. However, conflicting data have been published, and cross‐sectional studies have not reported hypometabolic patients. In conclusion, there is no consensus regarding the metabolic status of pre‐LTx and post‐LTx patients, which may be due to differences in the methods used for comparison. Therefore, we highlight this aspect of LTx patient management, which impacts the quality of nutrition therapy required by these patients.

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Body Composition and Overweight of Liver Transplant Recipients

Cited by 46 publications

References 26 publications

Early weight changes after liver transplantation significantly impact patient and graft survival

Early weight changes after liver transplantation significantly impact patient and graft survival

Excesso de peso em pacientes submetidos ao transplante hepático

Energy Expenditure and Liver Transplantation: What We Know and Where We Are

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