Children undergoing liver transplantation are at greater risk of
graft loss and death from adult organ donors who are severely obese
according to research published in the August issue of Liver Transplantation,
a journal of the American Association for the Study of Liver Diseases.
The study, funded in part by a grant from the National Institutes of
Health (NIH), found that pediatric donor body mass index (BMI) did not
increase mortality risk in this pediatric population.
Obesity is a global health concern. A 2008 report
from the World Health Organization (WHO) estimates that 1.4 billion
adults were overweight, and of these 200 million men and 300 million
women were classified as obese. WHO also reports that more than 40
million children under the age of five were overweight in 2010. In the
U.S., rates of being overweight or obese have risen in children and now
exceed 30% say experts.
Prior research shows the prevalence of overweight and
obese donors to adult liver transplant recipients has increased during
the last two decades. “Donor BMI is associated with post-transplant
obesity, but not survival rates of adult liver recipients,” explains
lead author Dr. Philip Rosenthal, from the University of California, San
Francisco’s Benioff Children’s Hospital. “Our study is the first to
evaluate the impact of donor BMI on pediatric liver transplant
Using data from the United Network for Organ Sharing
(UNOS), researchers identified 3788 pediatric liver transplants between
2004 and 2010. Analysis indicates that adult donor BMI 25-35 kg/m2
was not associated with graft loss or mortality in pediatric liver
recipients. However, adult donors with a BMI greater than 35 kg/m2
increased the risk of graft loss and death in children receiving
livers, after adjusting for other recipient, donor, and transplant risk
factors. The authors found that pediatric donor BMI was not associated
with graft or patient survival.
“While we found it common for adult donors to be
overweight or obese, our analysis suggests that BMI in the 25 to 35
range should not deter liver donation,” concludes Dr. Rosenthal. The
authors note that causes of graft loss, death, and donor steatosis could
not be determined due to lack of donor biopsies. Rosenthal added,
“Further research is needed to understand the impact of obesity on donor
acceptability and how this affects pediatric liver transplant
This study is published in Liver Transplantation. Media wishing to receive a PDF of this article may contact firstname.lastname@example.org.
Full citation: “An Evaluation of the Impact of
Donor BMI on Survival and Post-Transplant Obesity in Pediatric Liver
Transplant Recipients.” Emily Rothbaum Perito, Sue Rhee, Dave Glidden,
John Paul Roberts, Philip Rosenthal. Liver Transplantation; Published Online: July 24, 2012 (DOI: 10.1002/lt.23438) Print Issue Date: August, 2012.
About the Author: Dr. Philip Rosenthal is with
the University of California, San Francisco’s Benioff Children’s
Hospital. To arrange an interview with Dr. Rosenthal, please contact
Juliana Bunim with UCSF at email@example.com or at 415-476-8810.
About the Journal:
Liver Transplantation is published by Wiley on behalf of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.
Since the first application of liver transplantation in a clinical
situation was reported more than twenty years ago, there has been a
great deal of growth in this field and more is anticipated. As an
official publication of the AASLD and the ILTS, Liver Transplantation
delivers current, peer-reviewed articles on surgical techniques,
clinical investigations and drug research — the information necessary to
keep abreast of this evolving specialty. For more information, please
visit Liver Transplantation.
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