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2009, Number 1

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Ann Hepatol 2009; 8 (1)

Surgical morbidity in severely obese liver transplant recipients - A single Canadian Centre Experience

Schaeffer DF, Yoshida EM, Buczkowski AK, Chung SW, Steinbrecher UP, Erb SE, Scudamore CH
Full text How to cite this article

Language: English
References: 11
Page: 38-40
PDF size: 102.02 Kb.


Key words:

Orthotopic liver transplantation, obesity.

Text Extraction

The prevalence of obesity is increasing globally, with nearly half of a billion of the world’s population now considered to be overweight or obese. Obesity and overweight patients are one of the major health issues in Canada, resulting in approximately 57,000 deaths related to obesity over the last 15 years. The effect of obesity on outcomes following liver transplantation remains largely unclear. To determine the effect of obesity on outcome we reviewed 167 liver transplants, performed at the Vancouver General Hospital, between February 1999 and October 2003. Severe obesity was defined as body mass index (BMI) › 35 kg/m2 and moderate obesity as BMI of 30 – 34 kg/m2. One hundred forty three transplants were performed in patients with a body mass index (BMI) ‹ 30 kg/m2, 14 in patients with a BMI of 30 – 34 kg/m2, and 10 in patients with a BMI › 35 kg/m2. Non-weight related patient demographics were similar between the groups. A very high proportion of Hepatitic C patients (7/10) were observed in the severely obese group. In the early postoperative course severely obese patients had a higher rate of wound infection (20% vs. 4%, p = 0.0001) and wound dehiscence (40% vs. 1.2%, p = 0.0001). Within the first twelve postoperative months severely obese liver transplant recipients had a higher rate of ventral wound herniation (30% vs. 2.8%, p = 0.0001) when compared to obese or non-obese recipients. The one-year graft and patient survival were similar to non-obese patients. An increased BMI in liver transplant recipients in our centre did not increase the risk of early postoperative mortality, but did increase surgical complications, such as wound infection and wound dehiscence. The 1-year patient and graft survival however was indistinguishable from those of non-obese patients.


REFERENCES

  1. Katzmarzyk PT, Ardern CI. Overweight and obesity mortality trend in Canada. 1985-2000. Can J Public Health 2004; 95: 16-20.

  2. Flancbaum L, Choban PS. Surgical implications of obesity. Annu Rev Med 1998; 49: 215-234.

  3. Choban PS, Flancbaum L. The impact of obesity on surgical outcomes: A review. J Am Coll Surg 1997; 185: 593-603.

  4. Charlton M. Nonalcoholic fatty liver disease: A review of current understanding and future impact. Clin Gastroenterol Hepatol 2004; 2: 1048-1058.

  5. Angulo P. Nonalcoholic fatty liver disea. N Engl J Med 2002; 346: 1221-1231.

  6. Angulo P. Nonalcoholic fatty liver disease and liver transplantation. Liver Transpl 2006; 12: 523.534.

  7. Nair S, Verma S, Thuluvath PJ. Obesity and its effect on survival in patients undergoing orthotopic liver transplantation in the United States. Hepatology 2002; 35: 105-109.

  8. Leonhard J, Heimbach M, Malinchoc M, Watt K, Charlton M. The impact of obesity on long-term outcomes in Liver Transplant Recipients – results of the NIDDK liver transplant database. Am J Transpl 2008; 8: 667-672.

  9. Kral JG, Heymsfield S. Morbid obesity: definitions, epidemiology, and methodological problems. Gastroenterol Clin North Am 1987; 16: 197.

  10. Sawyer RG, Pelletier SJ, Pruett TL. Increased early morbidity and mortality with acceptable long-term function in severely obese patients undergoing liver transplantation. Clin Transplant 1999; 13(1 Pt 2): 126-130.

  11. Keeffe EB, Gettys C, Esquivel CO. Liver transplantation in patients with severe obesity. Transplantation 1994; 57: 309-311.




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Ann Hepatol. 2009;8