Morbid obesity and gross malnutrition are both poor predictors of outcomes after liver transplantation: What can we do about it?

✍ Scribed by Paul J. Thuluvath

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 75 KB
• Volume: 15
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.21824

✦ Synopsis

The prevalence of obesity in the general population is increasing in the United States and the rest of the world, and its impact on morbidity, mortality, and utilization of health resources continues to escalate in a significant manner. [1][2][3][4][5] Reports from the Centers for Disease Control and Prevention and the National Health and Nutrition Examination Surveys suggest that more than 20% of the US population is obese [ie, body mass index (BMI) Ͼ 30 kg/m 2 ]. In the past 2 decades, there has been a dramatic increase in the prevalence of obesity among liver transplantation (LT) recipients in the United States. The United Network for Organ Sharing (UNOS) database showed that, from 1988 to 1996, 16.8% of LT recipients had a BMI Ն 30 kg/m 2 ; of these, 5.3% were severely obese (BMI Ն 35 kg/m 2 ), and 2.1% were morbidly obese (BMI Ն 40 kg/ m 2 ). 6 The same database (Pelletier et al. 7 ) showed that, from 2001 to 2004, 32.5% of LT recipients were obese; of these, 8.4% were severely obese, and 3.2% were morbidly obese. Within a decade, it appears that the prevalence of obesity has increased by 93% among LT recipients, and more importantly, there has been a 58% increase in severe obesity as well as a 52% increase in morbid obesity. This increase is mostly a reflection of the changes in the general population and is also possibly due to an increase in the prevalence of nonalcoholic fatty liver disease (or cryptogenic cirrhosis) among