Effect of obesity on clinical outcomes in liver transplantation

Abstract

Severe obesity is often considered a relative contraindication for liver transplantation. The purpose of this study was to evaluate the impact of obesity on clinical measures of liver transplantation outcome. Six hundred eighteen patients underwent liver transplantation between 12/84 and 6/8/92; Body Mass Index (BMI) information was available for 391 patients. When these patients were stratified according to BMI, there were 299 non-obese patients (BMI < 27.8-men, < 27.3-women), 55 obese patients (BMI ≥ 27.8-men, ≥ 27.3-women), and 37 severely obese patients (BMI ≥ 31.1-men, ≥ 32.3-women). The groups were equal by age and sex. Hospital length of stay (LOS), ICU LOS, rates of wound infection, respiratory infection, respiratory failure (need for intubation), rejection, graft and patient survival were evaluated between the groups. Measures of outcome and morbidity were no worse in the obese/severely obese groups than in the non-obese group. An identical result was obtained when patients were classified into two groups (obese vs. non-obese). Wound infection, respiratory infection, and respiratory failure occurred more frequently in the severely obese group but were not significantly higher than the non-obese or obese groups. The hospital LOS tended to be longer in the severely obese patients when compared to the other groups. Chronic obesity alone should not be used as the only criteria to exclude patients from liver transplantation.