Prolonged Waiting Times for Liver Transplantation in Obese Patients

• DOI: 10.1097/sla.0b013e31818a01ef
• Publication Date: 2008-10-21T07:17:26Z
• Authors: Dorry L. Segev; Richard E. Thompson; Jayme E. Locke; Christopher E. Si...; Paul J. Thuluvath; Robert A. Montgomery; Warren R. Maley
• Keywords: Liver disease

To quantify the independent association between obesity and access to liver transplantation.Obesity is associated with higher complication rates, longer hospitalization, worse survival after transplantation. Nevertheless, transplantation provides benefit patients end-stage disease, regardless of body mass index (BMI). We hypothesized that, despite benefit, providers were reluctant transplant obese because inherent difficulty these cases their inferior outcomes. Our goal was BMI waiting time for orthotopic as a surrogate marker this reluctance.We studied 29,136 wait-list candidates in model disease (MELD) era, categorized severely (BMI 35-40), morbidly 40-60), reference 18.5-35). All models adjusted factors relevant allocation system, possibly influencing healthcare, biologically related progression outcomes.The odds receiving MELD exception 30% lower 38% patients. Similarly, likelihoods being turned down an organ 10% 16% higher, rates transplanted 11% 29% patients, respectively.Current practice seems indicate reluctance If indeed community we feel that allografts should not be distributed excessive postoperative risk, consider expressing formal change our policy rather than through informal patterns.