A new Mayo Clinic study found that liver transplants can be safely performed on clinically obese patients, says a clinic press release. The findings were recently reported at the International Liver Transplantation Society’s Annual International Congress in Rio de Janeiro, Brazil.
According to the International Liver Transplantation Society (ILTS) website, the ILTS was founded in 1990 and is comprised of more than 700 international members, including a wide variety specialists and health care providers. The society’s objective is to raise the standard of care for patients requiring liver transplantation and to promote education and research by disseminating and exchanging information related to liver transplantation within the medical community.
Dr. Michael Charlton is the Rochester, Minn., Mayo Clinic medical director of the liver transplant program. He is also the lead author of the study. The press release quotes Dr. Charlton: “Two-thirds of Americans are overweight or obese, and obesity-related liver disease is rapidly becoming the most common reason for liver transplantation. (And) because the majority of liver transplant candidates are overweight or obese, it has become vital to determine how this may affect the success of transplantation.”
A previous national study conducted with data from the United Network for Organ Sharing (UNOS) found that liver transplant patients who were obese (having a body mass index, or BMI, greater than 30) had poor outcomes following transplantation. Based on the study, many transplant centers in the United States currently will not perform liver transplants in patients with Class III obesity, meaning the patient has a BMI greater than 40.
The press release states that Dr. Charlton believes the previous study may have been flawed, however, because of the way BMI was calculated. Accumulation of fluid in the abdomen is a common side effect of liver disease, and unless the fluid weight was subtracted from the patient’s overall weight, the BMI would be inaccurate and would incorrectly categorize the patient in terms of obesity category.
That being the case, Dr. Charlton and his research team set out to determine if obesity, based on a revised BMI calculation, should prevent patients from receiving a liver transplant. They evaluated data from nearly 700 liver transplant recipients at Mayo Clinic in Rochester, the University of Nebraska Medical Center and the University of California, San Francisco, between 1990 and 1994. The press release says that the BMI before transplant was recalculated to adjust for fluid weight. Researchers then categorized the patients based on their adjusted obesity class and evaluated survival at 30 days and annually to 10 years. The findings showed that outcomes for patients who were overweight or obese were at least as good as for patients who were not considered overweight.
Of these findings, Dr. Charlton said: “This study, and our experience at Mayo Clinic, demonstrates the importance of considering each candidate for liver transplant individually and not automatically excluding patients based on BMI. Of course, weight reduction for obese patients will always provide health benefits, but weight alone should not be a barrier to liver transplantation.”
The press release states that the Mayo Clinic is the most experienced liver transplant center in the nation, with some of the highest survival rates in the world. More than 400 patients receive liver transplants every year at the clinic’s three sites, in Minnesota, Florida and Arizona.
Mayo Clinic, Mayo Clinic Study Finds Liver Transplantation Can Be Performed Safely for Obese Patients; http://www.mayoclinic.org/news2007-rst/4111.html
International Liver Transplant Society; http://www.ilts.org/join.cfm