Obese and Nonobese Recipients Had Similar Need for Ventilatory Support After Liver Transplantation

• Published in: Transplantation proceedings Vol. 43; no. 1; pp. 165 - 169
• Main Authors: Werneck, M, Afonso, R.C, Coelho, G.R, Sboarini, C, Coelho, M.P.V, Thomé, T, Lisboa, L.F, Ferraz Neto, B.H
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 2011; Elsevier
• Subjects: Biological and medical sciences; Body Mass Index; Case-Control Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Health Services Needs and Demand; Humans; Intensive Care Units; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - complications; Obesity - physiopathology; Respiration, Artificial; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue, organ and graft immunology; Human; Obesity; Support; Digestive system; Liver; Nutrition disorder; Recipient; Homotransplantation; Medicine; Need; Treatment; Surgery; Graft; Nutritional status; Liver transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.12.004

Abstract Background Obesity is a risk factor for patients undergoing major surgery. In liver transplantation, the morbidity and mortality in these patients may be higher owing to concomitant diseases that may prolong hospital stay. Moreover, the restrictive respiratory pattern in these patients, associated with pulmonary complications related to liver disease can impact the postoperative recovery. We sought to analyze the impact of high body mass index (BMI) on hospital and intensive care unit (ICU) stay, necessity and length of use either invasive and noninvasive ventilatory support in the early postoperative period after liver transplantation. Patients and Methods Between January 2007 and March 2009, we performed 85 liver transplantations in adult patients. BMI was calculated on the day of the transplantation. Data from 136 recipients undergoing OLT were reviewed by age, gender, etiology of liver disease, Model for End-Stage Liver Disease score, Child-Pugh class, cold and warm ischemic times, ICU stay, duration of invasive mechanical, and use of noninvasive ventilation (NIV). We divided the patients into 3 groups: Group 1, (normal weight BMI 18.5–24.99), versus group 2 overweight—BMI 25–29.99; versus group 3, obese—BMI ≥30. Results Groups 1, 2, and 3 had similar lengths of stay in the ICU, necessity of NIV as well as 6 month, 1- and 2-year survivals ( P > .05). Conclusion High BMI patients showed similar results to normal or overweight patients. Obesity should not be contraindication to liver transplantation.