Researchers from New Zealand report that morbidity after liver transplant is highest among obese patients with diabetes, but these risk factors do not influence post-transplant survival, according to a news release.
According to the study published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, body mass index is effective for assessing obesity in liver transplant patients.
Prior research shows that liver transplant recipients who develop post-transplant diabetes and metabolic syndrome are at increased risk of cardiovascular disease.
Metabolic syndrome is a combination of hypertension, high blood sugar and high cholesterol along with increased belly fat.
There is much evidence on post-transplant obesity and metabolic syndrome, Adam Bartlett, MD, lead author of the New Zealand study, said in the release. However, the impact of pre-transplant obesity, hypertension and coronary artery disease on post-transplant outcomes has received less attention and is the focus of our study.
BMI and percentage of body fat were measured before liver transplants in 202 patients at a New Zealand center between 2000 and 2010. Analyses of pre-transplant risk factors such as obesity, diabetes and coronary artery disease were conducted.
Analyses indicated obesity was an independent risk factor for diabetes and post-transplant complications. Diabetes in conjunction with obesity was the strongest predictor of complications after transplant and longer hospital stays.
Metabolic risk factors did not affect 30-day, one-year or five-year survival for liver transplant recipients.
Our study confirms that BMI is an appropriate measure of body fat and obesity alone should not prevent patients from receiving liver transplants, Bartlett said in the release. Identifying modifiable risk factors during the pre-transplant assessment allows for earlier interventions including weight control, diabetes management and coronary interventions such as stenting, all which may improve long-term outcomes following liver transplantation.
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