Influence of Donor Obesity on Long-Term Liver Transplantation Outcomes

Raya, A. Molina; Rabelo, Álvaro; Bastante, M. Domínguez; Suárez, Y. Fundora

doi:10.1016/j.transproceed.2018.03.134

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…To date studies evaluating the impact of donor obesity on outcomes after LT, showed no difference in terms of graft or patients survival compared with recipients of normal weight donors 24‐26 . Conversely, other studies showed an higher rate of PNF 27 and of acute kidney injury 28 .…”

Section: Discussionmentioning

confidence: 98%

“…To explore the reasons of this difference, risk factors for death or graft loss were evaluated in male and female transplanted patients To date studies evaluating the impact of donor obesity on outcomes after LT, showed no difference in terms of graft or patients survival compared with recipients of normal weight donors. [24][25][26] Conversely, other studies showed an higher rate of PNF 27 and of acute kidney injury. 28 However, none of these studies stratified patients according to recipient gender and therefore this could explain these controversial results.…”

Section: Evaluation Of Risk Factors Of Death/graft Loss In Male Andmentioning

confidence: 90%

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Influence of donor and recipient gender on liver transplantation outcomes in Europe

Germani

Zeni

Zanetto

et al. 2020

Liver International

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Background & Aims: The impact of gender and donor/recipient gender mismatch on LT outcomes is controversial. The aim of this study was to compare outcomes of LT in Europe, using the ELTR database, between male and female recipients, including donor/recipient gender mismatch. Methods: Recipient, donor and transplant characteristics were compared between male and female patients. Patient survival was compared between groups, and the impact of donor/recipient gender matching as well as donor and recipient anthropometric characteristics were evaluated as potential risk factors for post-LT death/graft loss. Results: A total of 46,334 LT patients were evaluated (70.5% men and 29.5% women). Ten-year survival rate was significantly higher in female than in male recipients (66% vs 59%, P < .

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Section: Discussionmentioning

confidence: 98%

Section: Evaluation Of Risk Factors Of Death/graft Loss In Male Andmentioning

confidence: 90%

Influence of donor and recipient gender on liver transplantation outcomes in Europe

Germani

Zeni

Zanetto

et al. 2020

Liver International

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“…5 , 6 Although the importance of donor BMI in LT outcomes is commonly mentioned, its role as an independent factor is not well characterized. Molina Raya et al 14 conducted a study with the aim to analyze LT outcomes according to donor BMI comparing recipients receiving a graft from an obese donor (BMI ≥30) versus those from a nonobese donor (BMI ≤30). The authors found no differences in survival or posttransplant complications among groups, with the exception of a longer, but not clinically relevant, ICU stay.…”

Section: Discussionmentioning

confidence: 99%

Liver Transplantation With Grafts From Super Obese Donors

Vargas

Cullen

Argo

et al. 2021

Transplantation Direct

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“…However, there was no significant difference in the rates of posttransplant complications or survival. (13) A systematic review of the impact of donor BMI (dBMI) on graft function in LT by Takagi et al based on donation after brain death (DBD) found that dBMI was not associated with inferior patient and graft survival in adult deceased donor liver transplantation. (14) There are limited data assessing the impact of morbid and super obese donors on posttransplant outcomes.…”

Section: Original Article | 1825mentioning

confidence: 99%

Perioperative Challenges in Patients Transplanted with Livers from Extreme Obese Donors

et al. 2021

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The combination of rising rates of obesity and the shortage of deceased donor livers have forced the consideration of marginal liver donors in terms of body mass index (BMI) for liver transplantation (LT). To date, there are still conflicting data on the impact of donor obesity on post‐LT outcomes. We analyzed all patients undergoing LT alone in the United States (US) from October 2005 through December 2019 using the United Network of Organ Sharing (UNOS) data set. We categorized donor BMI >40 kg/m2 as extremely obese (EO). Primary endpoints included 30‐day perioperative mortality and early graft loss (EGL) within 7 days. A subgroup analysis was performed for the EO donor group to assess how macrovesicular steatosis (MaS) >30% affects 30‐day mortality and EGL within 7 days. A total of 72,616 patients underwent LT during the study period. The 30‐day perioperative mortality was significantly higher in the EO donor group (P = 0.02). On multivariate analysis, recipients undergoing LT with EO donors had a 38% higher 30‐day mortality risk (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.21‐1.69) and 53% increased risk of EGL (OR, 1.53; 95% CI, 1.22‐1.90). MaS >30% was independently associated with a 2‐fold increased risk of 30‐day mortality (P = 0.003) and 3.5‐fold increased risk of EGL within 7 days (P < 0.001). The impact of MaS >30% in EGL was 2‐fold for all patients transplanted during the study period compared with 3.5‐fold in the EO donor group. There is an increased risk of EGL and 30‐day perioperative mortality in recipients transplanted with EO donors. Future studies are warranted in morbid and super obese donors to assess the possible effect of obesity‐related proinflammatory factors in EGL.

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Influence of Donor Obesity on Long-Term Liver Transplantation Outcomes

Cited by 6 publications

References 12 publications

Influence of donor and recipient gender on liver transplantation outcomes in Europe

Influence of donor and recipient gender on liver transplantation outcomes in Europe

Liver Transplantation With Grafts From Super Obese Donors

Perioperative Challenges in Patients Transplanted with Livers from Extreme Obese Donors

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