Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis
•The 2016 ISHLT listing criteria for heart transplantation recommended that recipients have a BMI
Gespeichert in:
| Veröffentlicht in: | The Journal of surgical research 2022-04, Vol.272, p.69-78 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 78 |
|---|---|
| container_issue | |
| container_start_page | 69 |
| container_title | The Journal of surgical research |
| container_volume | 272 |
| creator | Liu, Yuangao Padilla, Fernando A. Graviss, Edward A. Nguyen, Duc T. Lamba, Harveen K. Gnanashanmugam, Swami Chatterjee, Subhasis Suarez, Erik Bhimaraj, Arvind |
| description | •The 2016 ISHLT listing criteria for heart transplantation recommended that recipients have a BMI |
| doi_str_mv | 10.1016/j.jss.2021.11.005 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2613295106</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022480421007010</els_id><sourcerecordid>2613295106</sourcerecordid><originalsourceid>FETCH-LOGICAL-c353t-a8025fa14676dc1de9e53d972ece235fca38d273e6cc31b22afdc671424d86513</originalsourceid><addsrcrecordid>eNp9kE1vEzEURS1ERUPhB7BBXrKZqZ8945mBVZQCjVQ1Uj_WlmO_aR0mM8HPocq_x1ValqyennTule5h7BOIEgTo8025ISqlkFAClELUb9gMRFcXrW7UWzYTQsqiakV1yt4TbUT-u0a9Y6eq6pTuoJoxWu2Tm7ZIfOr5JdqY-F20I-0GOyZ-gy7sAo6J-FNIj3wxWCK-XPLVGimkw1c-5_djSOj5NaanKf7i_RT5Kj7Ykd8-2hjGB35hk11bQj4f7XCgQB_YSW8Hwo8v94zd__h-t7gsrlY_l4v5VeFUrVJhWyHr3kKlG-0deOywVr5rJDqUqu6dVa2XjULtnIK1lLb3TjdQycq3ugZ1xr4ce3dx-r1HSmYbyOGQp-G0JyM1KNnVIHRG4Yi6OBFF7M0uhq2NBwPCPLs2G5Ndm2fXBsBk1znz-aV-v96i_5d4lZuBb0cA88g_AaMhl2U69CGiS8ZP4T_1fwFIao-E</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2613295106</pqid></control><display><type>article</type><title>Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Liu, Yuangao ; Padilla, Fernando A. ; Graviss, Edward A. ; Nguyen, Duc T. ; Lamba, Harveen K. ; Gnanashanmugam, Swami ; Chatterjee, Subhasis ; Suarez, Erik ; Bhimaraj, Arvind</creator><creatorcontrib>Liu, Yuangao ; Padilla, Fernando A. ; Graviss, Edward A. ; Nguyen, Duc T. ; Lamba, Harveen K. ; Gnanashanmugam, Swami ; Chatterjee, Subhasis ; Suarez, Erik ; Bhimaraj, Arvind</creatorcontrib><description><![CDATA[•The 2016 ISHLT listing criteria for heart transplantation recommended that recipients have a BMI <35 kg/ m², putting obese individuals who need cardiac transplantation at a disadvantage.•Recipients with a BMI of 35 to 39.9 kg/ m² have better outcomes than do those with a BMI ≥40 kg/m2 and should be considered as a distinct group.•Selected individuals with a BMI of 35 to 39.9 kg/m2 should be considered as candidates for heart transplantation.•Improved quality of life and survival from a heart transplantation outweigh the risks associated with a BMI of 35 to 39.9 kg/m2.
In the 2016 ISHLT listing criteria guidelines for heart transplantation, recipients were recommended to have a body mass index (BMI) <35 kg/m². However, outcomes data for subgroups of transplant recipients with a BMI >35 kg/m² are limited. We examined the outcomes of heart transplant recipients who had a BMI of 35 to 39.9 kg/m² or ≥40 kg/m² and compared their outcomes with recipients who had a BMI <35 kg/m2.
Using data from the United Network for Organ Sharing database, we performed a retrospective cohort analysis of 23,009 adults who underwent cardiac transplantation between 2009 and 2018. Transplant recipients were stratified by BMI categories (<35 kg/m², 35-39.9 kg/m², and ≥40 kg/m²). Patient survival was depicted by Kaplan-Meier curves. Cox proportional-hazards modeling was used to determine the prognostic factors associated with mortality within 90 days, 1 year, and 5 years after transplantation.
Survival at 90 days, 1 year, and 5 years after transplantation was better in recipients who had a BMI <35 kg/m² than in those who had a BMI of 35 to 39.9 kg/m² (P values ranged from 0.01 to < 0.001) or ≥40 kg/m² (P < 0.001). Additionally, survival at 90 days (P < 0.001) and 1 year (P = 0.002) was significantly better in recipients who had a BMI of 35 to 39.9 kg/m² than in those who had a BMI ≥40 kg/m². In multivariate analysis, a BMI of 35 to 39.9 was significantly associated with increased 90-day mortality (HR = 1.53; 95% CI 1.12, 2.08; P = 0.01) but not increased 1-year (HR = 1.28; 95% CI 0.99, 1.66; P = 0.06) or 5-year mortality (HR = 1.11; 95% CI 0.91, 1.36; P = 0.29).
Although heart transplant recipients with class II obesity (BMI 35-39.9 kg/m²) may have suboptimal survival compared with those who have a BMI <35 kg/m², these patients have better outcomes than do those with class III obesity (BMI ≥40 kg/m²). Thus, contrary to current guidelines, selected patients with class II obesity should be considered for transplantation.]]></description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2021.11.005</identifier><identifier>PMID: 34936914</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Body Mass Index ; Cardiac transplantation ; Heart Transplantation ; Humans ; Obesity ; Obesity - complications ; Obesity - surgery ; Proportional Hazards Models ; Retrospective Studies ; Transplant Recipients ; Treatment Outcome</subject><ispartof>The Journal of surgical research, 2022-04, Vol.272, p.69-78</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-a8025fa14676dc1de9e53d972ece235fca38d273e6cc31b22afdc671424d86513</citedby><cites>FETCH-LOGICAL-c353t-a8025fa14676dc1de9e53d972ece235fca38d273e6cc31b22afdc671424d86513</cites><orcidid>0000-0002-5059-4404 ; 0000-0002-0803-8826 ; 0000-0003-3042-8027 ; 0000-0003-1024-5813</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2021.11.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34936914$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Yuangao</creatorcontrib><creatorcontrib>Padilla, Fernando A.</creatorcontrib><creatorcontrib>Graviss, Edward A.</creatorcontrib><creatorcontrib>Nguyen, Duc T.</creatorcontrib><creatorcontrib>Lamba, Harveen K.</creatorcontrib><creatorcontrib>Gnanashanmugam, Swami</creatorcontrib><creatorcontrib>Chatterjee, Subhasis</creatorcontrib><creatorcontrib>Suarez, Erik</creatorcontrib><creatorcontrib>Bhimaraj, Arvind</creatorcontrib><title>Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description><![CDATA[•The 2016 ISHLT listing criteria for heart transplantation recommended that recipients have a BMI <35 kg/ m², putting obese individuals who need cardiac transplantation at a disadvantage.•Recipients with a BMI of 35 to 39.9 kg/ m² have better outcomes than do those with a BMI ≥40 kg/m2 and should be considered as a distinct group.•Selected individuals with a BMI of 35 to 39.9 kg/m2 should be considered as candidates for heart transplantation.•Improved quality of life and survival from a heart transplantation outweigh the risks associated with a BMI of 35 to 39.9 kg/m2.
In the 2016 ISHLT listing criteria guidelines for heart transplantation, recipients were recommended to have a body mass index (BMI) <35 kg/m². However, outcomes data for subgroups of transplant recipients with a BMI >35 kg/m² are limited. We examined the outcomes of heart transplant recipients who had a BMI of 35 to 39.9 kg/m² or ≥40 kg/m² and compared their outcomes with recipients who had a BMI <35 kg/m2.
Using data from the United Network for Organ Sharing database, we performed a retrospective cohort analysis of 23,009 adults who underwent cardiac transplantation between 2009 and 2018. Transplant recipients were stratified by BMI categories (<35 kg/m², 35-39.9 kg/m², and ≥40 kg/m²). Patient survival was depicted by Kaplan-Meier curves. Cox proportional-hazards modeling was used to determine the prognostic factors associated with mortality within 90 days, 1 year, and 5 years after transplantation.
Survival at 90 days, 1 year, and 5 years after transplantation was better in recipients who had a BMI <35 kg/m² than in those who had a BMI of 35 to 39.9 kg/m² (P values ranged from 0.01 to < 0.001) or ≥40 kg/m² (P < 0.001). Additionally, survival at 90 days (P < 0.001) and 1 year (P = 0.002) was significantly better in recipients who had a BMI of 35 to 39.9 kg/m² than in those who had a BMI ≥40 kg/m². In multivariate analysis, a BMI of 35 to 39.9 was significantly associated with increased 90-day mortality (HR = 1.53; 95% CI 1.12, 2.08; P = 0.01) but not increased 1-year (HR = 1.28; 95% CI 0.99, 1.66; P = 0.06) or 5-year mortality (HR = 1.11; 95% CI 0.91, 1.36; P = 0.29).
Although heart transplant recipients with class II obesity (BMI 35-39.9 kg/m²) may have suboptimal survival compared with those who have a BMI <35 kg/m², these patients have better outcomes than do those with class III obesity (BMI ≥40 kg/m²). Thus, contrary to current guidelines, selected patients with class II obesity should be considered for transplantation.]]></description><subject>Adult</subject><subject>Body Mass Index</subject><subject>Cardiac transplantation</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - surgery</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Transplant Recipients</subject><subject>Treatment Outcome</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1vEzEURS1ERUPhB7BBXrKZqZ8945mBVZQCjVQ1Uj_WlmO_aR0mM8HPocq_x1ValqyennTule5h7BOIEgTo8025ISqlkFAClELUb9gMRFcXrW7UWzYTQsqiakV1yt4TbUT-u0a9Y6eq6pTuoJoxWu2Tm7ZIfOr5JdqY-F20I-0GOyZ-gy7sAo6J-FNIj3wxWCK-XPLVGimkw1c-5_djSOj5NaanKf7i_RT5Kj7Ykd8-2hjGB35hk11bQj4f7XCgQB_YSW8Hwo8v94zd__h-t7gsrlY_l4v5VeFUrVJhWyHr3kKlG-0deOywVr5rJDqUqu6dVa2XjULtnIK1lLb3TjdQycq3ugZ1xr4ce3dx-r1HSmYbyOGQp-G0JyM1KNnVIHRG4Yi6OBFF7M0uhq2NBwPCPLs2G5Ndm2fXBsBk1znz-aV-v96i_5d4lZuBb0cA88g_AaMhl2U69CGiS8ZP4T_1fwFIao-E</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Liu, Yuangao</creator><creator>Padilla, Fernando A.</creator><creator>Graviss, Edward A.</creator><creator>Nguyen, Duc T.</creator><creator>Lamba, Harveen K.</creator><creator>Gnanashanmugam, Swami</creator><creator>Chatterjee, Subhasis</creator><creator>Suarez, Erik</creator><creator>Bhimaraj, Arvind</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5059-4404</orcidid><orcidid>https://orcid.org/0000-0002-0803-8826</orcidid><orcidid>https://orcid.org/0000-0003-3042-8027</orcidid><orcidid>https://orcid.org/0000-0003-1024-5813</orcidid></search><sort><creationdate>202204</creationdate><title>Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis</title><author>Liu, Yuangao ; Padilla, Fernando A. ; Graviss, Edward A. ; Nguyen, Duc T. ; Lamba, Harveen K. ; Gnanashanmugam, Swami ; Chatterjee, Subhasis ; Suarez, Erik ; Bhimaraj, Arvind</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-a8025fa14676dc1de9e53d972ece235fca38d273e6cc31b22afdc671424d86513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Body Mass Index</topic><topic>Cardiac transplantation</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - surgery</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Transplant Recipients</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Yuangao</creatorcontrib><creatorcontrib>Padilla, Fernando A.</creatorcontrib><creatorcontrib>Graviss, Edward A.</creatorcontrib><creatorcontrib>Nguyen, Duc T.</creatorcontrib><creatorcontrib>Lamba, Harveen K.</creatorcontrib><creatorcontrib>Gnanashanmugam, Swami</creatorcontrib><creatorcontrib>Chatterjee, Subhasis</creatorcontrib><creatorcontrib>Suarez, Erik</creatorcontrib><creatorcontrib>Bhimaraj, Arvind</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Yuangao</au><au>Padilla, Fernando A.</au><au>Graviss, Edward A.</au><au>Nguyen, Duc T.</au><au>Lamba, Harveen K.</au><au>Gnanashanmugam, Swami</au><au>Chatterjee, Subhasis</au><au>Suarez, Erik</au><au>Bhimaraj, Arvind</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2022-04</date><risdate>2022</risdate><volume>272</volume><spage>69</spage><epage>78</epage><pages>69-78</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract><![CDATA[•The 2016 ISHLT listing criteria for heart transplantation recommended that recipients have a BMI <35 kg/ m², putting obese individuals who need cardiac transplantation at a disadvantage.•Recipients with a BMI of 35 to 39.9 kg/ m² have better outcomes than do those with a BMI ≥40 kg/m2 and should be considered as a distinct group.•Selected individuals with a BMI of 35 to 39.9 kg/m2 should be considered as candidates for heart transplantation.•Improved quality of life and survival from a heart transplantation outweigh the risks associated with a BMI of 35 to 39.9 kg/m2.
In the 2016 ISHLT listing criteria guidelines for heart transplantation, recipients were recommended to have a body mass index (BMI) <35 kg/m². However, outcomes data for subgroups of transplant recipients with a BMI >35 kg/m² are limited. We examined the outcomes of heart transplant recipients who had a BMI of 35 to 39.9 kg/m² or ≥40 kg/m² and compared their outcomes with recipients who had a BMI <35 kg/m2.
Using data from the United Network for Organ Sharing database, we performed a retrospective cohort analysis of 23,009 adults who underwent cardiac transplantation between 2009 and 2018. Transplant recipients were stratified by BMI categories (<35 kg/m², 35-39.9 kg/m², and ≥40 kg/m²). Patient survival was depicted by Kaplan-Meier curves. Cox proportional-hazards modeling was used to determine the prognostic factors associated with mortality within 90 days, 1 year, and 5 years after transplantation.
Survival at 90 days, 1 year, and 5 years after transplantation was better in recipients who had a BMI <35 kg/m² than in those who had a BMI of 35 to 39.9 kg/m² (P values ranged from 0.01 to < 0.001) or ≥40 kg/m² (P < 0.001). Additionally, survival at 90 days (P < 0.001) and 1 year (P = 0.002) was significantly better in recipients who had a BMI of 35 to 39.9 kg/m² than in those who had a BMI ≥40 kg/m². In multivariate analysis, a BMI of 35 to 39.9 was significantly associated with increased 90-day mortality (HR = 1.53; 95% CI 1.12, 2.08; P = 0.01) but not increased 1-year (HR = 1.28; 95% CI 0.99, 1.66; P = 0.06) or 5-year mortality (HR = 1.11; 95% CI 0.91, 1.36; P = 0.29).
Although heart transplant recipients with class II obesity (BMI 35-39.9 kg/m²) may have suboptimal survival compared with those who have a BMI <35 kg/m², these patients have better outcomes than do those with class III obesity (BMI ≥40 kg/m²). Thus, contrary to current guidelines, selected patients with class II obesity should be considered for transplantation.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34936914</pmid><doi>10.1016/j.jss.2021.11.005</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-5059-4404</orcidid><orcidid>https://orcid.org/0000-0002-0803-8826</orcidid><orcidid>https://orcid.org/0000-0003-3042-8027</orcidid><orcidid>https://orcid.org/0000-0003-1024-5813</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-4804 |
| ispartof | The Journal of surgical research, 2022-04, Vol.272, p.69-78 |
| issn | 0022-4804 1095-8673 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2613295106 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Body Mass Index Cardiac transplantation Heart Transplantation Humans Obesity Obesity - complications Obesity - surgery Proportional Hazards Models Retrospective Studies Transplant Recipients Treatment Outcome |
| title | Outcomes of Heart Transplant Recipients with Class II Obesity: A United Network for Organ Sharing Database Analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T01%3A36%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Outcomes%20of%20Heart%20Transplant%20Recipients%20with%20Class%20II%20Obesity:%20A%20United%20Network%20for%20Organ%20Sharing%20Database%20Analysis&rft.jtitle=The%20Journal%20of%20surgical%20research&rft.au=Liu,%20Yuangao&rft.date=2022-04&rft.volume=272&rft.spage=69&rft.epage=78&rft.pages=69-78&rft.issn=0022-4804&rft.eissn=1095-8673&rft_id=info:doi/10.1016/j.jss.2021.11.005&rft_dat=%3Cproquest_cross%3E2613295106%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2613295106&rft_id=info:pmid/34936914&rft_els_id=S0022480421007010&rfr_iscdi=true |