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Prognostic impact and risk factors of low body mass index in patients undergoing liver transplantation
Author(s) -
Lee JinChiao,
Doush Wael M. A.,
Wang YuChao,
Cheng ChihHsien,
Wu TsungHan,
Chen YiChan,
Soong RueyShyang,
Wu TingJung,
Chou HongShiue,
Chan KunMing,
Lee WeiChen,
Lee ChenFang
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13048
Subject(s) - medicine , underweight , hazard ratio , body mass index , liver transplantation , confidence interval , transplantation , population , gastroenterology , risk factor , surgery , overweight , environmental health
We aimed to investigate the effect of body mass index ( BMI ) on the overall survival rates and to identify the risk factors associated with adverse outcomes. A total of 381 adult‐to‐adult living donor liver transplantations performed were retrospectively analyzed. These patients were classified according to the BMI categories established by the World Health Organization: The underweight group ( BMI <18.5 kg/m 2 ) and the non‐underweight group ( BMI ≥18.5 kg/m 2 ). The underweight group had significantly worse outcomes, compared with that of the non‐underweight group (5‐year overall survival: 45.6% vs 74.6%, P <.001). Underweight patients with CD 4/ CD 8 ratio <1.4 had a significant worse prognosis, compared with those with CD 4/ CD 8 ratio ≥1.4. (The 1‐, 3‐, and 5‐year overall patient survival rates in both groups were 71.0% vs 20%, 58.9% vs 0%, and 53.6% vs 0%, respectively, P =.002.) In the multivariate analysis, only CD 4/ CD 8 ratio <1.4 was an independent poor prognostic factor (hazard ratio=7.063, 95% confidence interval=1.329‐37.547, P =.022). Conclusions Pre‐operative CD 4/ CD 8 ratio <1.4 is an independent poor prognostic indicator for underweight patients undergoing liver transplantation. Early intervention in replenishing the nutrient deficit and cautious use of immunosuppressive regimens are essential to prepare this high‐risk population for a more successful liver transplantation.