Systematic review with meta‐analysis: post‐operative complications and mortality risk in liver transplant candidates with obesity

摘要: SummaryBackground International guidelines rate class III (morbid) obesity (body mass index [BMI]≥40 kg/m2) as a relative contraindication for liver transplantation (LT) requiring further research. Moreover, data on the mortality risk in candidates with BMI: 30-34.9 and 35-39.9 kg/m2 (class I II obesity, respectively) are weak. Aim Herein, we compared post-operative complications risks all obese vs 18.5-29.9 (normal/overweight) assumed controls. Methods We searched Cochrane library, PubMed, Scopus, Web-of-Science article reference lists, restricted to English language, selected cohort studies analysing following outcomes: all-causes (at 30 days, 1-2-3-5 years), cardiopulmonary complications, hospital intensive care unit (ICU) length of stay. Two reviewers independently extracted third one resolved discrepancies. Results Twenty-four comprising 132 162 patients met inclusion criteria. As controls, was increased at time-periods (except 3 years) BMI≥40, days none considered 35-39.9. Post-operative were significantly higher BMI>30 30-34.9. Due shortage/absence data, evaluated ICU stay only BMI≥30 category. In these patients, controls. Conclusions Morbid has an impact patients’ survival after LT. However, since even increases post-transplant new strategies should be included LT programme favour weight loss candidates.