Turkish Journal of Gastroenterology
Oral Presentation

Outcomes after live donor liver transplantation based on donor BMI

1.

Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine

2.

Department of Surgery, Division of Transplantation, Johns Hopkins University School of Medicine, Turkey

Turk J Gastroenterol 2019; 30: Supplement 2-2
DOI: 10.5152/tjg.2019.02
Read: 1128 Downloads: 86 Published: 25 July 2019

Abstract

INTRODUCTION: Live liver donors with BMI >30 are usually not considered for donation due to concerns of fatty changes and post-surgical complications. We aimed to evaluate the post-transplant outcomes for both donors and recipients with different BMIs and characteristics. 

 

METHODS: Records of donors and their recipients who underwent adult to adult live donor liver transplantation (LDLT) between 2013 and 2018 at Johns Hopkins were reviewed. Liver steatosis >20% was excluded in all donors by imaging or liver biopsy. Survival curves were generated using Kaplan–Meier plots. Significant variables had P-values <0.05.

 

RESULTS: 43 donors and 43 recipients were identified. 54.7% of donors were male, had a mean BMI of 26, average age of 34.6 years and length of stay of 7.23 days. 90-day outcomes were measured and complications were reported in 11 donors. Two donors visited the ED for pain. Four needed admission with duration of 1 to 4 days. No mortality was reported in the donors. 17 donors had BMI<25, 9 BMI 25 to <28, 9 BMI 28 to <30 and 7 BMI ≥ 30. Recipients had an average age of 51.9 years, BMI 26.3, MELD of 13.8 and 64.2% were male. The most common indications for LDLT were NASH cirrhosis (23.8%), alcohol (21.43%) and PSC (16.6%). The right lobe was used in 85.7% of patients. Recipients were followed for a median of 884 (9-1984) days. Two recipients needed retransplantation within one year and overall 3 expired. Donor BMI was not associated to complication rates, ED visits or readmission among donors. Furthermore no difference was observed in recipient mortality (p=0.2) or need for retransplantation (p=0.3). 

 

CONCLUSION: We conclude that LDLT from donors with BMI≥ 30 in the absence of graft steatosis has similar outcomes than donors with BMI <30 and can be considered for LDLT.

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