Obesity in Patients after Liver Transplantation

Abstract

Post-transplant obesity has recently become a subject of interest as part of the metabolic syndrome evolving after transplantation, jeopardizing the gain of patient prognosis achieved by transplantation. Considering this scenario and the importance of the prevention of obesity in liver graft survivors, nutritional status should be monitored in all post-transplant patients leading to appropriate nutritional treatment. The aim of the present study was to evaluate the nutritional status of post-liver transplant patients. The sample consisted of a group of patients submitted to liver transplantation and a control group of patients without liver disease. Nutritional status was assessed by body composition and anthropometric methods. Body mass index indicating overweight and obesity was observed in liver transplant patients regardless of the post-liver transplantation period. Waist circumference was greater than the value recommended by the World Health Organization, i.e., 94 cm for men and 80 cm for women, in 78% of < 1 year post-transplant patients and in 79% of ≥ 1 year post-transplant patients. In addition, arm circumference and fat arm area measures diagnosed overweight / obesity only in ≥ 1 year post-transplant patients and controls. Patients with a longer post-transplant period had a mean phase angle similar to that of the control group, while patients with a shorter post-transplant period had a lower mean phase angle. These results suggest a full recovery from surgery and a health improvement after transplantation since the phase angle is a measure related to nutritional status and prognosis. In conclusion, although the post-liver transplantation population studied may have had a full recovery and health improvement after surgery, obesity and excessive body fat mass are prevalent and may be deleterious in the long term in view of the associated risk of cardiovascular events.