Influence of Body Mass Index on Venous Thrombotic Complications of Liver Transplants

Molina, Ana Ramı́rez de; Vilchez, A.; Domínguez, Minia Campos; García, A.; Miguel, Carolyn; González, Adel; Fundora, Y.

doi:10.1016/j.transproceed.2016.10.001

Cited by 6 publications

(15 citation statements)

References 20 publications

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“…Seventeen studies lacking data of vascular complications and 1 study [19] of pediatric patients were excluded. There were 2 studies with overlapping cohorts from the same institution [14, 20], and only the latest report [14] was included. Two studies did not use 30 kg/m 2 as the BMI threshold.…”

Section: Resultsmentioning

confidence: 99%

“…There was a significantly higher rate of deep venous thrombosis in patients with a BMI > 40 kg/m 2 compared to those with a normal BMI. Other studies also reported that obese LT recipients had a trend toward a higher risk of vascular complications after transplantation, though differences between groups were not statistically significant [14, 15]. On the other hand, a retrospective cohort study including 1325 LT recipients showed that obese patients had a slightly decreased rate of vascular complications, but again the difference between groups was not significant [16].…”

Section: Introductionmentioning

confidence: 99%

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The Association of obesity with vascular complications after liver transplantation

et al. 2019

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Background Because of the growing number of obese patients undergoing liver transplantation (LT), it is important to investigate the impact of obesity on post-transplant outcomes. Vascular complications are rare, but serious causes of morbidity and mortality after LT. It is not known if pre-transplant obesity is associated with an increased incidence of post-LT vascular complications. Methods Medline, Embase, and Cochrane Library databases were searched in September 2017. The primary outcome was the impact of obesity on the vascular complication rate in adult LT recipients. Survival and biliary complications rates were also analyzed. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to compare pooled data between groups with a body mass index (BMI) ≥ 30 kg/m 2 and < 30 kg/m 2 . Results Six retrospective cohort studies with a total of 987 patients with a BMI ≥ 30 kg/m 2 (high BMI group) and 2911 patients with a BMI < 3 0 kg/m 2 (control group) were included in the analysis. All studies had Newcastle-Ottawa Scale scores ≥4. The vascular complication rates were similar between the high BMI group and control group (RR = 1.13, 95% CI: 0.87–1.47, P = 0.27), as were the patient survival, graft survival, and biliary complication rates. In subgroup analysis, there was no difference in the vascular complication rates between BMI ≥ 35 vs. BMI < 25 kg/m 2 ; BMI 30–35 vs. BMI 18–25 kg/m 2 ; BMI ≥ 30 vs. BMI 18–25 kg/m 2 ; and BMI ≥ 35 vs. BMI < 35 kg/m 2 . No difference was found in subgroup analysis when BMI was adjusted for ascites. However, recipients whose primary disease was alcoholic liver disease, those with a BMI ≥ 30 kg/m 2 had higher incidence of vascular complications than those with a BMI < 30 kg/m 2 (RR = 1.55, 95% CI: 1.07–2.25, P = 0.02) . Conclusions BMI does not affect incidence of vascular complications after LT. High pre-transplant BMI is not a risk factor for patient survival and biliary complications after LT. Electronic supplementary material The online version of this article (10.1186/s12876-019-0954-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Association of obesity with vascular complications after liver transplantation

et al. 2019

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“…For this reason, only the 1‐year mortality from the larger study was included in our analysis . Twenty studies were retrospective and four prospective . Sample sizes ranged from 40 to 69 619 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Sample sizes ranged from 40 to 69 619 patients. In detail, eight studies included less than 200 patients, 11 studies included 200‐1000 patients, and five studies more than 1000 patients …”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: post‐operative complications and mortality risk in liver transplant candidates with obesity

Barone

Viggiani

Losurdo

et al. 2017

Aliment Pharmacol Ther

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“…In our series, patients that were overweight or obese had twice the risk of PVT compared to those with a normal weight or underweight. There was no statistically significant association between BMI and thrombotic complications in the study by Molina et al (22). The authors concluded that obesity does not seem to be a risk factor that reduces graft or patient survival.…”

Section: Discussionmentioning

confidence: 85%

Risk factors and impact of portal vein thrombosis in liver transplantation

et al. 2019

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Introduction: portal vein thrombosis is a relatively common complication of advanced cirrhosis that increases perioperative risk in liver transplant recipients. This condition was characterized in a cohort of patients, including risk factors and their influence on survival. Material and methods: a retrospective study of liver transplant recipients at the Clínica Universidad de Navarra was performed between 2000 and 2015. Differences in clinical and biological characteristics and survival were analyzed in subjects with and without portal vein thrombosis. A predictive index was also developed. Results: a total of 288 patients were included in the study, portal vein thrombosis was recorded in 46 (16%) cases and seven (15.2%) had stage 3/4 disease according to Yerdel's classification. Factors associated with the presence of esophageal/gastric varices (OR = 3.7; p = 0.03) included variceal ligation or sclerotherapy (OR = 2.3; p = ligation/sclerotherapy, thrombocytopenia and being overweight/obesity was associated with a higher rate of portal vein thrombosis. Advanced stages had an impact on survival.

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Influence of Body Mass Index on Venous Thrombotic Complications of Liver Transplants

Cited by 6 publications

References 20 publications

The Association of obesity with vascular complications after liver transplantation

The Association of obesity with vascular complications after liver transplantation

Systematic review with meta‐analysis: post‐operative complications and mortality risk in liver transplant candidates with obesity

Risk factors and impact of portal vein thrombosis in liver transplantation

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