Morbidity is increased in the early postoperative phase following liver transplant for patients who have obesity with diabetes mellitus, according to research published in Liver Transplantation.
In an effort to assess the influence of pre-transplant risk variables on postoperative morbidity and survival, Anna J. Dare, M.B.Ch.B., of the University of Auckland in New Zealand, and colleagues analyzed data from a cohort of 202 consecutive patients receiving a liver transplant. Variables included coronary artery disease, diabetes mellitus, hypertension, and obesity.
The researchers found a high level of agreement (86 percent) between body mass index and percentage of body fat for the classification of patients as obese or non-obese. Independent factors that increased risk for a higher postoperative event rate included diabetes mellitus (counts ratio [CR], 1.4; P < 0.001) and obesity (CR, 1.03; P < 0.001). The strongest predictor of increased risk for higher postoperative event rate (CR, 1.75; P < 0.001) and longer hospital stay (5.81 days; P < 0.01) was obesity with concomitant diabetes mellitus. No effect on survival (30-day, one-year, or five-year) was observed for independent metabolic risk factors.
“Early post-liver transplantation morbidity is highest in patients with concomitant obesity and diabetes mellitus, though these factors do not appear to influence recipient survival,” the authors write.