Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect
There is a paucity of literature examining recipient-donor obesity matching on liver transplantation outcomes. The United Network for Organ Sharing database was queried for first-time recipients of liver transplant whose age was ≥18 between January 2003 and September 2013. Outcomes including patient...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2016/9709430 |
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| author | Eliza W. Beal Dmitry Tumin Lanla F. Conteh A. James Hanje Anthony J. Michaels Don Hayes Sylvester M. Black Khalid Mumtaz |
| author_facet | Eliza W. Beal Dmitry Tumin Lanla F. Conteh A. James Hanje Anthony J. Michaels Don Hayes Sylvester M. Black Khalid Mumtaz |
| author_sort | Eliza W. Beal |
| collection | DOAJ |
| description | There is a paucity of literature examining recipient-donor obesity matching on liver transplantation outcomes. The United Network for Organ Sharing database was queried for first-time recipients of liver transplant whose age was ≥18 between January 2003 and September 2013. Outcomes including patient and graft survival at 30 days, 1 year, and 5 years and overall, liver retransplantation, and length of stay were compared between nonobese recipients receiving a graft from nonobese donors and obese recipient-obese donor, obese recipient-nonobese donor, and nonobese recipient-obese donor pairs. 51,556 LT recipients were identified, including 34,217 (66%) nonobese and 17,339 (34%) obese recipients. The proportions of patients receiving an allograft from an obese donor were 24% and 29%, respectively, among nonobese and obese recipients. Graft loss (HR: 1.27; 95% CI: 1.09–1.46; p=0.002) and mortality (HR: 1.38; 95% CI: 1.16–1.65; p<0.001) at 30 days were increased in the obese recipient-obese donor pair. However, 1-year graft (HR: 0.83; 95% CI: 0.74–0.93; p=0.002) and patient (HR: 0.84; 95% CI: 0.74–0.95; p=0.007) survival and overall patient (HR: 0.93; 95% CI: 0.86–1.00; p=0.042) survival were favorable. There is evidence of recipient and donor obesity disadvantage early, but survival curves demonstrate improved long-term outcomes. It is important to consider obesity in the donor-recipient match. |
| format | Article |
| id | doaj-art-3c279ebbf64a4ccba5f1afb97afd42fb |
| institution | OA Journals |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-3c279ebbf64a4ccba5f1afb97afd42fb2025-08-20T02:08:16ZengWileyJournal of Transplantation2090-00072090-00152016-01-01201610.1155/2016/97094309709430Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not PerfectEliza W. Beal0Dmitry Tumin1Lanla F. Conteh2A. James Hanje3Anthony J. Michaels4Don Hayes5Sylvester M. Black6Khalid Mumtaz7Department of General Surgery, Division of Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USADepartment of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USADepartment of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USADepartment of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USADepartment of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USADepartment of Internal Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USADepartment of General Surgery, Division of Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USADepartment of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USAThere is a paucity of literature examining recipient-donor obesity matching on liver transplantation outcomes. The United Network for Organ Sharing database was queried for first-time recipients of liver transplant whose age was ≥18 between January 2003 and September 2013. Outcomes including patient and graft survival at 30 days, 1 year, and 5 years and overall, liver retransplantation, and length of stay were compared between nonobese recipients receiving a graft from nonobese donors and obese recipient-obese donor, obese recipient-nonobese donor, and nonobese recipient-obese donor pairs. 51,556 LT recipients were identified, including 34,217 (66%) nonobese and 17,339 (34%) obese recipients. The proportions of patients receiving an allograft from an obese donor were 24% and 29%, respectively, among nonobese and obese recipients. Graft loss (HR: 1.27; 95% CI: 1.09–1.46; p=0.002) and mortality (HR: 1.38; 95% CI: 1.16–1.65; p<0.001) at 30 days were increased in the obese recipient-obese donor pair. However, 1-year graft (HR: 0.83; 95% CI: 0.74–0.93; p=0.002) and patient (HR: 0.84; 95% CI: 0.74–0.95; p=0.007) survival and overall patient (HR: 0.93; 95% CI: 0.86–1.00; p=0.042) survival were favorable. There is evidence of recipient and donor obesity disadvantage early, but survival curves demonstrate improved long-term outcomes. It is important to consider obesity in the donor-recipient match.http://dx.doi.org/10.1155/2016/9709430 |
| spellingShingle | Eliza W. Beal Dmitry Tumin Lanla F. Conteh A. James Hanje Anthony J. Michaels Don Hayes Sylvester M. Black Khalid Mumtaz Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect Journal of Transplantation |
| title | Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect |
| title_full | Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect |
| title_fullStr | Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect |
| title_full_unstemmed | Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect |
| title_short | Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect |
| title_sort | impact of recipient and donor obesity match on the outcomes of liver transplantation all matches are not perfect |
| url | http://dx.doi.org/10.1155/2016/9709430 |
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