Obese Fare Well After Heart Transplant
Study Shows Survival Rates Similar Among Obese and Lean Patients
By
Neil Osterweil
WebMD Health News
Reviewed By
Elizabeth Klodas, MD
April 11, 2008 (Boston) — Heart transplant recipients who are obese or even extremely obese
at the time of surgery seem to do just as well as lean heart transplant
patients, said researchers at a heart and lung transplant meeting here.
In a study of 430 patients who underwent a heart transplant at Temple
University Hospital in Philadelphia over a 10-year period, there were no major
differences in survival rates among patients with lean, moderately obese, or
extremely obese bodies, says Abul Kashem, MD, PhD.
The researchers looked at records on all patients who underwent a heart
transplant at their center from 1992 through 2002. They divided the patients
into three groups according to BMI: less than 31 (normal to moderately
overweight; 367 patients), 31-35 (obese; 52 patients) and greater than 35
(extremely obese; 11 patients).
Survival Rates and Weight
When they looked at survival by weight they found that the
leanest group of patients had 91% survival in the first month after surgery,
compared with 88% for those in the 31-35 BMI category, and 81% in those with
BMIs of 36 and up. There was a slight decline in survival rates after one year
among the extremely obese patients, but the survival rate stayed steady after
that and remained so out to 10 years, Kashem says. Furthermore, BMI was not
associated with need for additional surgery, post-surgery infections, or length
of stay.
When they analyzed the data according to other risk factors, they found that
age of the organ recipient and the organ donor, female gender,
organ-preservation time before transplantation, kidney function, and high blood
pressure were each separately associated with the likelihood of survival.
"Our results show BMI was not an independent risk factor for mortality
in this study, and no level of BMI led to significantly worse survival,"
Kashem says. "Obesity should not be a contraindication to
transplantation."
Kashem acknowledges that the study was limited by the relatively small
numbers of patients in the two obesity categories, and by the fact that they
did not consider weight change among patients from the beginning of the study
to other study time points.
The study was presented at the 28th annual meeting and scientific sessions
of the International Society for Heart and Lung Transplantation.
SOURCES: International Society for Heart and Lung Transplantation 28th Annual
Meeting and Scientific Sessions, Boston, April 9-12, 2008. Abul Kashem, MD, PhD, Temple University School of Medicine,
Philadelphia. The Journal of Heart and Lung Transplantation, February 2008; vol 27
issue 2, supplement 1: p S116. DOI: 10.1016/j.healun.2007.11.164.
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