J. van Son, S.P. Stam, A.W. Gomes Neto, J. Blokzijl, A.P. van den Berg, R.J. Porte, S.J.L. Bakker, V.E. de Meijer
Thursday 14 march 2019
13:33 - 13:35h at Tropentheater
Categories: Klinisch/Basaal, Parallelsessie
Parallel session: Parallelsessie XV – Basaal / Klinisch 2
Background: Short-term survival after orthotopic liver transplantation (OLT) has improved over the past decades, but long-term survival remains impaired. The effects of obesity on long-term survival after OLT remain controversial. Because pre-transplant body mass index (BMI) can be confounded by for example ascites, we hypothesized that post-transplant BMI at 1 year could be a predictor of long term survival.
Methods: In a single-center retrospective cohort study 370 adult OLT recipients were included. Baseline BMI was set at 1 year post-transplantation to represent a stable condition. Patients were stratified into 3 BMI categories: normal weight with BMI2(n=184), overweight with 25≤BMI≤30 kg/m2(n=136), and obese with BMI>30 kg/m2(n=50). Survival analyses were performed according to Kaplan-Meier with log-rank testing, followed by Cox proportional-hazards regression analyses.
Results: After a median follow-up of 12.3 years (interquartile range 8.4-17.5 years), 132 (35.6%) patients deceased. As a continuous variable, higher BMI was inversely associated with 15 year overall survival (HR = 1.07, 95% CI: 1.02-1.12, P= 0.002), independent of age, sex, and total body muscle mass measured by urinary creatinine excretion rate. Obese OLT recipients had a significantly decreased 15 years survival of 56%, when compared to 75% survival rate of normal weight OLT recipients (HR = 1.80, 95% CI: 1.07-3.03, P= 0.026).
Conclusions: Post-transplant BMI is inversely associated with long-term survival after OLT. Obesity at 1 year post-transplantation is associated with poor survival, which may offer potential interventional strategies (i.e. dietary advice and lifestyle modification) to improve long-term survival of obese OLT recipients.