Short- and Long-Term Impacts of Overweight Status on Outcomes Among Living Liver Donors |
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| Institution: | 1. Division of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan;2. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan;3. Osaka International Cancer Institute, Osaka, Japan;1. Department of Surgery, Westmead Hospital, Sydney, Australia;2. Department of transplantation, Royal Prince Alfred Hospital, Sydney, Australia;3. University of Sydney, Specialty of Surgery, Sydney, Australia;4. Royal Prince Alfred Institute of Academic Surgery, Sydney, Australia;1. Department of Medicine, Cleveland Clinic, Cleveland, Ohio;2. Department of Medicine, University of Missouri, Kansas City, Missouri;3. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio;1. Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá D.C Colombia;2. Cardiology Unit - Heart Failure and Heart Transplant Clinic, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá D.C Colombia;1. King''s College Hospital, London, United Kingdom;2. Institute of Medical Statistics and Medical Informatics, School of Medicine, Belgrade, Serbia;3. Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil;1. Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan;2. Japan Society for the Promotion of Science, Tokyo, Japan;3. School of Psychological Science, Health Sciences University of Hokkaido, Hokkaido, Japan;4. Department of Kidney Transplant Surgery, Sapporo City General Hospital, Hokkaido, Japan;5. Harada Jinhinyoki Clinic, Hokkaido, Japan;6. Goryo-kaku Nephro Clinic, Hokkaido, Japan;7. Kitahara Life Support Clinic, Tokyo, Japan;1. Department of Surgery and Surgical Intensive Care, University Hospital Regensburg, Regensburg, Germany;2. Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany |
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| Abstract: | PurposeIn recent years, the increasing number of obese individuals in Japan has made transplant teams sometimes forced to select candidates with a high body mass index (BMI) as marginal donors in living donor liver transplantation. However, data are lacking regarding the impact of a high BMI on the outcome for liver donors, particularly over the long term. Here, we aimed to clarify the impact of a high BMI on postoperative short- and long-term outcomes in liver donors.MethodsWe selected 80 cases that had complete 5-year data available from hepatectomies performed in 2005 to 2015 in our institute. We divided donors into overweight (BMI ≥ 25 kg/m2, n = 16) and normal-weight (BMI < 25, n = 64) groups.ResultsPreoperatively, the overweight group had significantly higher preoperative levels of serum alanine aminotransferase and γ-glutamyl transpeptidase and a larger liver volume than the normal-weight group. Although the overweight group had significantly greater intraoperative blood loss (660 ± 455 vs 312 ± 268 mL, P = .0018) and longer operation times (463 ± 88 vs 386 ± 79 min, P = .0013), the groups showed similar frequencies of postoperative complications. At 1 year post hepatectomy, liver regeneration and spleen enlargement ratios did not significantly differ between the 2 groups. Remarkably, the overweight group showed significantly higher serum γ-glutamyl transpeptidase levels over the long term.ConclusionsOverweight status alone was not a risk factor for either short- or long-term postoperative outcomes after a donor hepatectomy. However, donors with elevated γ-glutamyl transpeptidase levels, which was frequent among overweight donors, may require special attention. |
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