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Body weight parameters are related to morbidity and mortality after liver transplantation - A systematic review and meta-analysis

Beckmann, Sonja and Drent, Gerda and Ruppar, Todd and Nikolic, Nataša and De Geest, Sabina. (2019) Body weight parameters are related to morbidity and mortality after liver transplantation - A systematic review and meta-analysis. Transplantation, 103 (11). pp. 2287-2303.

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Abstract

Weight gain and obesity are well-known clinical issues in liver transplantation (LTx). However, their impacts on patient outcomes remain unclear, as only the impact of pre-LTx BMI on survival has been meta-analyzed. We summarized and synthesized the evidence on pre- and post-LTx body weight parameters' relationships with post-LTx outcomes such as survival, metabolic and cardiovascular comorbidities, and healthcare utilization.; We followed the Cochrane Handbook for Systematic Reviews of Interventions' recommendations. Quality was assessed via a 19-item instrument. Odds ratios and 95% confidence intervals were calculated for outcomes investigated in ≥5 studies.; Our meta-analysis included 37 studies. Patients with pre-LTx BMI ≥30 kg/m and BMI ≥35 kg/m had lower overall survival rates than those with pre-LTx normal weight (72.6% and 69.8% vs. 84.2% p=0.02 and p=0.03, respectively). Those with pre-LTx BMI ≥30 kg/m had worse overall graft survival than normal weight patients (75.8% and 85.4%, p=0.003). Pre-LTx BMI and pre-LTx overweight were associated with new-onset diabetes (p<0.001 and p=0.015, respectively), but post-LTx BMI showed no relationship. No associations were evident with healthcare utilization.; Patients with BMI values ≥30 kg/m had worse patient and graft survival than those with normal weight. Few of the reviewed studies examined post-LTx body weight parameters or other relevant outcomes such as cardiovascular comorbidities. High heterogeneity as well as diverse definitions and operationalizations of measurement and outcomes severely impeded comparability.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Institut für Pflegewissenschaft
UniBasel Contributors:Beckmann, Sonja and De Geest, Sabina M.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Lippincott Williams & Wilkins
ISSN:0041-1337
e-ISSN:1534-6080
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:09 Dec 2019 15:03
Deposited On:06 Nov 2019 10:10

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