首页|Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis
Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis
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NSTL
Elsevier
Background: In the 2016 ISHLT listing criteria guidelines for heart transplantation, recipients were recommended to have a body mass index (BMI) <35 kg/m(2). However, outcomes data for subgroups of transplant recipients with a BMI >35 kg/m(2) are limited. We examined the outcomes of heart transplant recipients who had a BMI of 35 to 39.9 kg/m(2) or >= 40 kg/m(2) and compared their outcomes with recipients who had a BMI <35 kg/m(2). Methods: Using data from the United Network for Organ Sharing database, we performed a retrospective cohort analysis of 23,009 adults who underwent cardiac transplantation between 2009 and 2018. Transplant recipients were stratified by BMI categories (<35 kg/m(2), 35-39.9 kg/m(2), and >= 40 kg/m(2)). Patient survival was depicted by Kaplan-Meier curves. Cox proportional-hazards modeling was used to determine the prognostic factors associated with mortality within 90 days, 1 year, and 5 years after transplantation. Results: Survival at 90 days, 1 year, and 5 years after transplantation was better in recipients who had a BMI <35 kg/m(2 )than in those who had a BMI of 35 to 39.9 kg/m(2) (P values ranged from 0.01 to < 0.001) or >= 40 kg/m(2) (P < 0.001). Additionally, survival at 90 days (P < 0.001) and 1 year (P = 0.002) was significantly better in recipients who had a BMI of 35 to 39.9 kg/m(2) than in those who had a BMI >= 40 kg/m(2). In multivariate analysis, a BMI of 35 to 39.9 was significantly associated with increased 90-day mortality (HR = 1.53; 95% CI 1.12, 2.08; P = 0.01) but not increased 1-year (HR = 1.28; 95% CI 0.99, 1.66; P = 0.06) or 5-year mortality (HR = 1.11; 95% CI 0.91, 1.36; P = 0.29). Conclusions: Although heart transplant recipients with class II obesity (BMI 35-39.9 kg/m(2) may have suboptimal survival compared with those who have a BMI <35 kg/m(2), these patients have better outcomes than do those with class III obesity (BMI >= 40 kg/m(2)). Thus, contrary to current guidelines, selected patients with class II obesity should be considered for transplantation. (C) 2021 Elsevier Inc. All rights reserved.
Cardiac transplantationObesityBody mass indexBODY-MASS INDEXCARDIAC-SURGERYPARADOXMORTALITYSURVIVALSOCIETYADULTSIMPACT
Liu, Yuangao、Padilla, Fernando A.、Graviss, Edward A.、Nguyen, Duc T.、Lamba, Harveen K.、Gnanashanmugam, Swami、Chatterjee, Subhasis、Suarez, Erik、Bhimaraj, Arvind
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Sch Med,Baylor Coll Med
Houston Methodist Res Inst
Div Cardiothorac Transplantat & Circulatory Suppo,Baylor Coll Med
JC Walter Jr Transplant Ctr,Houston Methodist Hosp
NSTL
Elsevier
