WEIGHT CHANGE AND OBESITY AFTER LIVER-TRANSPLANTATION - INCIDENCE ANDRISK-FACTORS

Obesity is a concern in the long-term management of patients following liver transplantation, yet the risk of obesity and the factors that i nfluence its development have not been well defined. We evaluated post transplantation weight change among a cohort of 774 adults who had the ir height and weight recorded before liver transplantation at three ma jor centers, Obesity was defined as a body mass index (BMI) of at leas t 30 kg/m(2). Weight at transplantation was adjusted by the amount of ascites removed. Mean BMI increased from 24.8 kg/m(2) pretransplantati on to 27.0 kg/m(2) in the first posttransplantation year, to 28.1 kg/m (2) in the second year, and very little with subsequent observation, A mong 320 patients who were not obese before transplantation, 21.6% bec ame obese within 2 years after transplantation. On evaluation of numer ous potential donor and pretransplantation risk factors, greater recip ient BMI, greater donor BMI, and being married were found to be predic tors of subsequent obesity (P <.05), Posttransplantation predictors of obesity included absence of acute cellular rejection, higher cumulati ve prednisone dose in the second year, and cyclosporine-based immunosu ppression, although only rejection and prednisone dose remained predic tors on multivariate analysis, Despite the marked weight gain after tr ansplantation, prevalence of obesity at 2 years was only slightly grea ter than in the general US population. Obesity occurred commonly after liver transplantation, sometimes with a striking gain in weight, In a ddition to BMI at transplantation, donor BMI, marital status, occurren ce of acute rejection, and prednisone dose affected the incidence of o besity, Copyright (C) 1998 by the American Association for the Study o f Liver Diseases.