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Patients Benefit from Liver Transplantation, Fat or Thin

Obesity should not be a contraindication to liver transplantation, authors conclude

MONDAY, Dec. 10 (HealthDay News) -- Regardless of their body mass index, patients with end-stage liver disease do better when they undergo liver transplantation versus no transplantation, according to a report published in the December issue of Liver Transplantation.

Shawn J. Pelletier, M.D., of the University of Michigan in Ann Arbor, and colleagues analyzed data from the Scientific Registry of Transplant Recipients in order to investigate the association between body mass index and liver transplant survival benefit. Of the 25,647 patients awaiting transplant, 4,488 eventually received a liver during the study period.

Underweight patients had the highest risk of death while on the waiting list, but had similar mortality rates after transplantation as normal weight patients. In all patients, regardless of body mass index, liver transplantation was associated with improved survival, and the authors conclude that obesity should not be a contraindication for liver transplantation.

In an accompanying editorial, Paul Thuluvath, M.D., of Johns Hopkins Hospital in Baltimore takes the debate further, suggesting that only relatively healthier obese patients should undergo liver transplantation. "Morbidly obese patients with one or more other serious comorbidities…should not be offered liver transplantation. This process will allow us to offer liver transplantation in a 'selective' manner to some morbidly obese patients, thereby assuring a low morbidity and a better long-term survival. That should be our goal," Thuluvath concludes.

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