studies

242A AASLD ABSTRACTS HEPATOLOGY, October, 2015
Disclosures:
Bart van Hoek - Advisory Committees or Review Panels: Janssen-Cilag, Bristol
Meyers Squib, Gilead, Merck, Abbvie
Robert A. de Man - Advisory Committees or Review Panels: Norgine; Grant/
Research Support: Biotest
Henk R. van Buuren - Grant/Research Support: Intercept, Zambon Nederland BV
The following authors have nothing to disclose: Annemarie C. de Vries, Madelon
Tieleman, Aad P. van den Berg, Wojciech G. Polak, Jan Ringers, Robert J. Porte,
Cynthia Konijn, Bettina E. Hansen, Herold J. Metselaar
69
Liver Transplant Outcomes and Survival Benefit for
Obese Patients in the United States: Are We Disadvantaging
the Morbidly Obese?
Barry Schlansky 1 , Willscott E. Naugler 1 , Susan L. Orloff 2 , C. Kristian
Enestvedt 2 ; 1 Gastroenterology/Hepatology, Oregon Health &
Science University, Portland, OR; 2 Abdominal Organ Transplantation,
Oregon Health & Science University, Portland, OR
Purpose. Over 85% of U.S. centers adhere to national practice
guidelines that consider morbid obesity to be a contraindication
to liver transplantation (LT) based on inferior post-LT
survival compared to the non-obese. In the present era, LT outcomes
and survival benefit for obese patients have not been
well studied. Methods. We evaluated the association of body
mass index (BMI) with wait list and post-LT outcomes in patients
wait listed for LT from 2005 to 2014, using the United Network
for Organ Sharing database. We categorized BMI by the
World Health Organization classification, with 18.5-29.9 kg/
m 2 defining normal weight, 30-34.9 obesity, 35-39.9 severe
obesity, and ≥40 morbid obesity. We followed patients from
LT to death or graft loss, from wait listing to death before LT
or receipt of LT, and from wait listing to death before or after
LT (intention-to-treat, ITT). We used Cox regression to evaluate
post-LT and ITT mortality and LT survival benefit, and competing
risk regression to evaluate wait list mortality versus receipt
of LT. We also explored temporal trends of these outcomes
in an expanded cohort from 2002. Results. 3.9% of 80,221
waitlisted patients and 3.5% of 38,177 transplanted patients
were morbidly obese. ITT survival was lower for morbidly
obese compared to lower BMI patients (log-rank p