Influence of Donor Obesity on Long-Term Liver Transplantation Outcomes

Abstract Objective To analyze liver transplantation outcomes according to the body mass index (BMI) of donors. Material and Methods A retrospective descriptive study was conducted in patients transplanted at our center between January 2006 and December 2014, comparing outcomes between grafts from obese (body mass index [BMI] ≥30) and nonobese (BMI ≤30) donors. We analyzed the reasons for transplantation, the morbidity-mortality related variables, and survival after a minimum follow-up of 24 months. A multivariate logistic model was constructed to predict the mortality. Survival was analyzed with the Kaplan-Meier method, and survival curves were compared using the log-rank test. Results The study included 50 obese and 175 nonobese donors. A significant difference between the groups was found in the pre-extraction intensive care unit (ICU) stay of the donors ( P  = .006) but not in the post-transplantation complications or survival of the respective recipients ( P > .05). In the multivariate analysis, mortality was significantly associated with the presence of the hepatitis C virus (HCV) ( P  = .001) in the recipient and with the age of the donor ( P  = .043), finding the risk of death to be 2.87-fold higher in patients with HCV versus without HCV (95% confidence interval [1.641–5.043]) and 1.7% higher with every additional year of donor age (odds ratio 1.017, 95% confidence interval [1–1.034]). Conclusions A significantly longer pre-extraction ICU stay was observed in obese (BMI ≥30) versus nonobese (BMI