Open AccessObesity does not significantly impact outcomes following simultaneous liver kidney transplantation: review of the UNOS database ‐ a retrospective study
Author(s) -
Yu Jonathan W.,
Gupta Gaurav,
Kang Le,
Bandyopadhyay Dipankar,
Siddiqui Mohammed S.,
Bhati Chandra S.,
Stravitz Richard T.,
Levy Marlon,
Reichman Trevor W.
Publication year - 2019
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.13352
Subject(s) - medicine , contraindication , kidney transplantation , overweight , diabetes mellitus , obesity , body mass index , liver transplantation , transplantation , kidney , surgery , gastroenterology , database , endocrinology , pathology , alternative medicine , computer science
Summary 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 BMI s ≥ 40.