Obese Children Getting New Liver Face Long-Term Risk

Risk of late mortality is higher in these patients; thin patients have increased risk of early mortality

THURSDAY, Nov. 4 (HealthDay News) -- Obese pediatric patients undergoing liver transplantation have a higher risk of late mortality than normal and overweight patients, while thin and extremely thin patients have higher risk of early mortality, according to research published in the November issue of Liver Transplantation.

Andre A.S. Dick, M.D., of the University of Washington in Seattle, and colleagues analyzed data from 9,701 patients under the age of 18 who received primary liver transplantation from 1987 through 2007. They put patients into five body mass index (BMI) categories according to z score based on age, gender, and BMI.

The researchers found that thin and severely thin patients had lower survival at one year compared to normal and overweight patients (84.4 versus 88.7 percent). Obese patients had similar early survival after transplantation, but by 12 years, they had significantly lower survival compared to normal and overweight groups (72 versus 77 percent).

"Obesity in the pediatric population is an alarming issue. With early identification and appropriate and aggressive management, excellent long-term health outcomes, as well as acceptable graft survival, can be achieved. Donor organs are a scarce resource, and the goal of transplantation is to maximize long-term patient and graft survival. Pre-transplant as well as post-transplant identification of patients who are malnourished or obese, and optimization of their modifiable risk factors, will help us make the best use of this scarce resource and potentially maximize patient and graft survival," the authors conclude.

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