Obesity as predictor of postoperative outcomes in liver transplant candidates: Review of the literature and future perspectives

Alfonso Wolfango Avolio, Michele Barone, Maria Teresa Viggiani, Andrea Iannone, Maria Rendina, Alfredo Di Leo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

14 Citazioni (Scopus)

Abstract

Background Current American and European guidelines consider a pre-transplant BMI ≥40 kg/m2as a relative contraindication for liver transplantation but this recommendation is graded as uncertain and requires further research. Moreover, conflicting results are reported on the predictive value of BMI 30–39.9 kg/m2on post-transplant complication and mortality risk. Aim This study analyzed the data of the literature on the effect of all three BMI classes of obesity on postoperative outcomes in liver transplantation. Materials and methods A PubMed and Cochrane Library search was conducted from inception to October 2015. Results Analysis of the literature demonstrates that discrepancies among studies are mainly either due to limitations of BMI per se, the different BMI cut-offs used to select patients with obesity or reference group and the different outcomes considered. Moreover, the evaluation of visceral adipose tissue and the detrimental effect of muscle mass reduction in presence of obesity are never considered. Conclusions BMI assessment should be used as a preliminary method to evaluate obesity. Subsequently, the assessment of visceral adipose tissue and muscle mass should complete the preoperative evaluation of liver transplant candidates. This innovative approach could represent a new field of research in liver transplantation.
Lingua originaleEnglish
pagine (da-a)957-966
Numero di pagine10
RivistaDIGESTIVE AND LIVER DISEASE
Volume49
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Body Mass Index
  • Body mass index
  • Gastroenterology
  • Hepatology
  • Humans
  • Intra-Abdominal Fat
  • Liver Transplantation
  • Muscle, Skeletal
  • Obesity
  • Postoperative Complications
  • Risk Factors
  • Sarcopenia
  • Visceral adipose tissue

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