van der Heijden, FJ (2020) The Influence of Donor-Recipient Obesity Pairing on Postoperative Complications, Metabolic Related Diseases, and Graft and Patient Survival. thesis, Medicine.
Full text available on request.Abstract
Introduction | Obesity related non-alcoholic fatty liver disease is projected to become the leading indication for liver transplant in the near future. On the side of the donor, obesity is also a growing problem because high steatosis is associated with poorer graft function and high re-LT rates. Our aim was to evaluate the influence of recipient obesity and donor-recipient obesity pairing on recipient outcomes after liver transplant. Methods | A single centre, retrospective cohort study (n=716) was performed to determine the mean BMI of liver transplant recipients between 2007 and 2019. Transplant outcomes were compared between obese and non-obese recipients and between (Non) Obese Recipient – (Non) Obese Donor pairs (NOD-NOR, OD-OR, NOD-OR and OD-NOR) in a cohort study (n=175) from 2007 to 2011, allowing a follow-up of at least five years. Obesity was defined based on BMI. Outcomes included patient- and graft survival, causes of death and causes of retransplantation, postoperative complications, metabolic related diseases and the BMI. Results | In our centre, there was no significant increase in obese recipients over time. A significant positive association was observed between time and posttransplant BMI (p<0.02). Graft- and patient survival was similar across all categories. Obese recipients showed longer ICU-stay (3 vs 2 days, p=0.015), more posttransplant dyslipidaemia (94% vs 75%, p=0.002) and infection as main cause of death (57% vs 25%, p=0.047) compared to non-obese recipients. OD-pairs died significantly more often from graft failure compared to NOD and NOR pairs (100% vs 26% and 0%, p= 0,004). No differences were found between patient and graft survival. Conclusion | Posttransplant management in obese recipients should focus on minimizing infection and dyslipidaemia and monitoring the graft function from obese donors. Moreover, both donor and recipient obesity should not be a reason not to conduct a livertransplant.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Drs. Hofker, HS and Dr. de Jonge, J and Dr. Darwish Murad, S |
| Faculty: | Medical Sciences |
| Date Deposited: | 09 Oct 2023 11:26 |
| Last Modified: | 09 Oct 2023 11:26 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3701 |
Actions (login required)
 |
View Item |