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. 2020 Jan;26(1):68-79.
doi: 10.1002/lt.25672.

Posttransplant Outcome of Lean Compared With Obese Nonalcoholic Steatohepatitis in the United States: The Obesity Paradox

Sanjaya K Satapathy  1   2 , Yu Jiang  3 , Uchenna Agbim  4 , Cen Wu  5 , David E Bernstein  1   2 , Lewis W Teperman  6 , Satish K Kedia  3 , Guruprasad P Aithal  7 , Kalyan Ram Bhamidimarri  8 , Ajay Duseja  9 , Rakhi Maiwall  10 , Benedict Maliakkal  4 , Prasun Jalal  11 , Keyur Patel  12 , Puneet Puri  13 , Ravi Ravinuthala  14 , Vincent Wai-Sun Wong  15 , Manal F Abdelmalek  16 , Aijaz Ahmed  17 , Paul J Thuluvath  18 , Ashwani K Singal  19 ; Global NAFLD Consortium
Affiliations

Posttransplant Outcome of Lean Compared With Obese Nonalcoholic Steatohepatitis in the United States: The Obesity Paradox

Sanjaya K Satapathy et al. Liver Transpl. 2020 Jan.

Abstract

Morbid obesity is considered a relative contraindication for liver transplantation (LT). We investigated if body mass index (BMI; lean versus obese) is a risk factor for post-LT graft and overall survival in nonalcoholic steatohepatitis (NASH) and non-NASH patients. Using the United Network for Organ Sharing (UNOS) database, LT recipients from January 2002 to June 2013 (age ≥18 years) with follow-up until 2017 were included. The association of BMI categories calculated at LT with graft and overall survival after LT were examined. After adjusting for confounders, all obesity cohorts (overweight and class 1, class 2, and class 3 obesity) among LT recipients for NASH had significantly reduced risk of graft and patient loss at 10 years of follow-up compared with the lean BMI cohort. In contrast, the non-NASH group of LT recipients had no increased risk for graft and patient loss for overweight, class 1, and class 2 obesity groups but had significantly increased risk for graft (P < 0.001) and patient loss (P = 0.005) in the class 3 obesity group. In this retrospective analysis of the UNOS database, adult recipients selected for first LT and NASH patients with the lowest BMI have the worse longterm graft and patient survival as opposed to non-NASH patients where the survival was worse with higher BMI.

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References

    1. World Health Organization. https://www.who.int/topics/obesity/en/. Accessed November 12, 2019.
    1. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 2016;315:2284-2291.
    1. Nair S, Vanatta JM, Arteh J, Eason JD. Effects of obesity, diabetes, and prior abdominal surgery on resource utilization in liver transplantation: a single-center study. Liver Transpl 2009;15:1519-1524.
    1. Bambha KM, Dodge JL, Gralla J, Sprague D, Biggins SW. Low, rather than high, body mass index confers increased risk for post-liver transplant death and graft loss: risk modulated by Model for End-Stage Liver Disease. Liver Transpl 2015;21:1286-1294.
    1. Parikh ND, Marrero WJ, Wang J, Steuer J, Tapper EB, Konerman M, et al. Projected increase in obesity and non-alcoholic-steatohepatitis-related liver transplantation waitlist additions in the United States. Hepatology 2019;70:487-495.

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