Review article
The effect of donor body mass index on graft function in liver transplantation: A systematic review

https://doi.org/10.1016/j.trre.2020.100571Get rights and content
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Highlights

  • The impact of donor body mass index (BMI) on graft function outcomes in liver transplantation (LT) is controversial.

  • In adult deceased donor and living donor LT, donor BMI was not associated with graft and patient survival.

  • High donor BMI was associated with a higher chance of macrosteatosis besides a higher incidence of declined livers.

Abstract

The impact of donor body mass index (BMI) on graft function outcomes in liver transplantation (LT) is still controversial. The aim of this study was to review the current evidence investigating the effect of donor BMI on outcomes in patients undergoing LT. A systematic review was performed to evaluate relevant outcomes such as the availability of data on donor BMI as well as graft and patient survival after LT. Screening of 901 articles resulted in 11 observational studies for data extraction. In adult deceased donor after brain death and living donor LT, donor BMI was not associated with graft and patient survival. However, high donor BMI was associated with a higher chance of macrosteatosis besides a significantly higher incidence of declined livers. In pediatric LT, severe obesity in adult donors with BMI ≥35 was associated with graft loss and mortality, whereas obesity in pediatric donors was not associated with graft loss and mortality. Accordingly, donor BMI is not associated with long-term outcomes in adult patients undergoing LT. However, further research should be conducted to identify the effect of donor BMI on outcomes in LT.

Keywords

Body mass index
Donor
Graft function
Liver transplantation
Outcome

Abbreviations

ECD
extended criteria donor
BMI
body mass index
LT
liver transplantation
DRI
Donor Risk Index
UNOS
United Network for Organ Sharing
DDLT
deceased donor liver transplantation
LDLT
living donor liver transplantation
OR
odds ratio
PNF
primary non-function
DBD
donors after brain death
DCD
donors after circulatory death
HR
hazard ratio
CI
confidence interval

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