Body weight parameters are related to morbidity and mortality after liver transplantation - A systematic review and meta-analysis.
Beckmann, S., et al. (2019).Transplantation 24: 24.
Aims
This systematic review aimed to summarise the evidence available on the impact of pre- and post-liver transplant (LTx) body weight parameters (e.g., BMI, BMI category, post-transplant weight gain) on post-transplant outcomes such as patient and graft survival, metabolic and cardiovascular comorbidities and healthcare use.
Interventions
Medline via PubMed, Cochrane library, CINAHL, PsycINFO, and EMBASE databases were searched without filters or limits. The inclusion criteria included quantitative or mixed method studies on first time solid organ transplant recipients that examined pre- and post-LTx body weight parameters related to any post-LTx outcome.
Participants
37 studies comprising body weight parameters pre and post liver-transplant surgeries.
Outcomes
Outcomes assessed included body weight parameters associated with patient survival, graft survival, new on-set diabetes and length of hospital stay, pre and post-liver transplant.
Follow-up
3 Years
CET Conclusions
The systematic review evaluated the evidence on the impact of pre- and post-liver transplantation body weight parameters on posttransplant outcomes. The comprehensive literature search was conducted in February 2016. Study selection and data extraction were done by independent reviewers. The methodological quality was assessed using a 19-item tool. The search identified 184 studies for inclusion that reported posttransplant outcomes of which 37 were included in meta-analyses. Liver transplant recipients with a pre-transplant BMI≥30 or BMI≥35 had worse overall patient survival when to compared to patients with normal weight. Graft survival was worse in patients with a BMI≥30 when compared to patients with normal weight and there was a significant relationship between pretransplant BMI and development of new-onset diabetes after 6 months posttransplant. Posttransplant BMI was not shown to be associated the development of new-onset diabetes. The authors attempted to explain high heterogeneity by conducting explorative subgroup analyses. The methodological quality inadequate for most trials and the authors suggested that this may have caused the high heterogeneity.
Trial registration
PROSPERO - CRD42014009151