Open AccessNew‐onset obesity after liver transplantation—outcomes and risk factors: the Swiss Transplant Cohort Study
Author(s) -
Beckmann Sonja,
Denhaerynck Kris,
Stampf Susanne,
SaigiMorgui Nuria,
Binet Isabelle,
Koller Michael,
Boely Elsa,
De Geest Sabina
Publication year - 2018
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13308
Subject(s) - medicine , obesity , hazard ratio , cumulative incidence , liver transplantation , proportional hazards model , transplantation , cohort , risk factor , confidence interval
Summary Weight gain after liver transplantation ( LT x) facilitates development of new‐onset obesity; however, its risk factors and outcomes are poorly understood. We identified the impact of new‐onset obesity on cardiovascular events ( CVE s) and patient survival, and risk factors for new‐onset obesity. Multiple Cox regression models examined risk factors for CVE s, patient survival, and new‐onset obesity in 253 adults (mean age 52.2 ± 11.6 years, male gender 63.6%, mean follow up 5.7 ± 2.1 years). Cumulative incidence of post‐ LT x CVE was 28.1%; that of new‐onset obesity was 21.3%. Regardless of CVE at LT x, post‐ LT x CVE s were predicted by new‐onset obesity [Hazard Ratio ( HR ), 2.95; P = 0.002] and higher age at LT x ( HR , 1.05; P < 0.001). In patients without known pre‐ LT x CVE s ( n = 214), risk factors for post‐ LT x CVE s were new‐onset obesity ( HR , 2.59; P = 0.014) and higher age ( HR , 1.04; P = 0.001). Survival was not associated with new‐onset obesity ( P = 0.696). Alcoholic liver disease predicted new‐onset obesity ( HR , 3.37; P = 0.025), female gender was protective ( HR , 0.39; P = 0.034). In 114 patients with available genetic data, alcoholic liver disease ( HR , 12.82; P = 0.014) and hepatocellular carcinoma ( HR , 10.02; P = 0.048) predicted new‐onset obesity, and genetics remained borderline significant ( HR , 1.07; P = 0.071). Early introduction of post‐ LT x weight management programs may suggest a potential pathway to reduce CVE risk.