The impact of race and comorbid conditions on adult liver transplant outcomes in obese recipients
AUTHORS
- PMID: 34580936 [PubMed].
ABSTRACT
Many prior studies comparing liver transplant outcomes between obese and non-obese recipients found no significant differences in survival. However, obesity is intrinsically associated with demographic factors such as race and comorbidities. Thus, this work aimed to analyze the effects of obesity, in conjunction with these factors, on liver transplant outcomes. OPTN data was analyzed to identify adult-only, first-time liver transplants between 1995 and 2019. Obesity was defined by the CDC obesity classification. Race, insurance status, age, and comorbidities were analyzed together with patient survival and graft survival using a multivariable Cox Proportional-Hazards model and long-term survival with Kaplan-Meier curves. The multivariable models found that being black, older than 50 years, having diabetes, or having non-private insurance were all risk factors for both patient survival and graft survival after liver transplant. Adjusting for obesity class, black recipients had a 20% lower patient survival and 23% lower graft survival compared to non-black recipients. Survival curves verified that obese black liver transplant recipients had poorer long-term patient survival and graft survival compared to both obese non-black and non-obese recipients. In conclusion, obesity compounds other known factors associated with poor outcomes after liver transplantation. Further work is critical to understand why these discrepancies persist.
Tags: alumni publications 2021