Impact of Recipient Body Mass Index on Short-Term and Long-Term Survival of Pancreatic Grafts

被引:36
作者
Bedat, Benoit [1 ,2 ]
Niclauss, Nadja [1 ,2 ]
Jannot, Anne-Sophie [2 ,3 ]
Andres, Axel [1 ,2 ]
Toso, Christian [1 ,2 ]
Morel, Philippe [1 ,2 ]
Berney, Thierry [1 ,2 ]
机构
[1] Univ Hosp Geneva, Div Visceral & Transplantat Surg, Dept Surg, Geneva, Switzerland
[2] Univ Geneva, Sch Med, CH-1211 Geneva, Switzerland
[3] Univ Hosp Geneva, Div Clin Epidemiol, Geneva, Switzerland
基金
瑞士国家科学基金会;
关键词
POSTTRANSPLANT DIABETES-MELLITUS; RENAL-TRANSPLANT OUTCOMES; RISK-FACTORS; LIVER-TRANSPLANTATION; US ADULTS; OBESITY; SURGERY; PREVALENCE; OVERWEIGHT;
D O I
10.1097/TP.0000000000000226
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. The impact of recipient body mass index on graft and patient survival after pancreas transplantation is not well known. Methods. We have analyzed data from all pancreas transplant recipients reported in the Scientific Registry of Transplant Recipients between 1987 and 2011. Recipients were categorized into BMI classes, as defined by the World Health Organization. Short-term (90 days) and long-term (90 days to 5 years) patient and graft survivals were analyzed according to recipient BMI class using Kaplan-Meier estimates. Hazard ratios were estimated using Cox proportional hazard models. Results. A total of 21,075 adult recipients were included in the analysis. Mean follow-up was 5 +/- 1.1 years. Subjects were overweight or obese in 39%. Increasing recipient BMI was an independent predictor of pancreatic graft loss and patient death in the short term (P<0.001), especially for obese class II patient survival (hazard ratio, 2.07; P=0.009). In the long term, obesity, but not overweight, was associated with higher risk of graft failure (P=0.01). Underweight was associated with a higher risk of long-term death (P<0.001). Conclusion. These results question the safety of pancreas transplantation in obese patients and suggest that they may be directed to alternate therapies, such as behavioral modifications or bariatric surgery, before pancreas transplantation is considered.
引用
收藏
页码:94 / 99
页数:6
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