New-onset obesity after liver transplantation-outcomes and risk factors: the Swiss Transplant Cohort Study

Article Article scientifique Article New-onset obesity after liver transplantation-outcomes and risk factors: the Swiss Transplant Cohort Study eng 2018-11 author Beckmann Sonja author Denhaerynck Kris author Stampf Susanne author Saigi-Morgui Nuria author Binet Isabelle author Koller Michael 830283 author Janke Elsa 743705 author De Geest Sabina Psychosocial Interest Group Swiss Transplant Cohort Study 1254-1267 10.1111/tri.13308 29984844 0934-0874 Weight gain after liver transplantation (LTx) facilitates development of new-onset obesity; however, its risk factors and outcomes are poorly understood. We identified the impact of new-onset obesity on cardiovascular events (CVEs) and patient survival, and risk factors for new-onset obesity. Multiple Cox regression models examined risk factors for CVEs, patient survival, and new-onset obesity in 253 adults (mean age 52.2 ± 11.6 years, male gender 63.6%, mean follow up 5.7 ± 2.1 years). Cumulative incidence of post-LTx CVE was 28.1%; that of new-onset obesity was 21.3%. Regardless of CVE at LTx, post-LTx CVEs were predicted by new-onset obesity [Hazard Ratio (HR), 2.95; P = 0.002] and higher age at LTx (HR, 1.05; P < 0.001). In patients without known pre-LTx CVEs (n = 214), risk factors for post-LTx CVEs were new-onset obesity (HR, 2.59; P = 0.014) and higher age (HR, 1.04; P = 0.001). Survival was not associated with new-onset obesity (P = 0.696). Alcoholic liver disease predicted new-onset obesity (HR, 3.37; P = 0.025), female gender was protective (HR, 0.39; P = 0.034). In 114 patients with available genetic data, alcoholic liver disease (HR, 12.82; P = 0.014) and hepatocellular carcinoma (HR, 10.02; P = 0.048) predicted new-onset obesity, and genetics remained borderline significant (HR, 1.07; P = 0.071). Early introduction of post-LTx weight management programs may suggest a potential pathway to reduce CVE risk. Adult Aged Body Weight Carcinoma Hepatocellular/complications/surgery Female Humans Liver Diseases Alcoholic/complications Liver Neoplasms/complications/surgery Liver Transplantation Male Middle Aged Obesity/complications/etiology Proportional Hazards Models Prospective Studies Risk Risk Factors Switzerland Transplants Treatment Outcome Weight Gain Dewey 617 Swiss National Science Foundation Schweizerische Transplantationskohorte 134267 CH Programmes 57 Département de chirurgie 222 false 235 Perception du Quorum et gènes de virulence 301 562 Transplantation et hépatologie 905 Transplant International 31 11 06abc00e-b10f-42a2-afb7-85cbc1cbd1bb Article (Published version) Restricted Beckmann_et_al-2018-Transplant_International.pdf 358436 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

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New-onset obesity after liver transplantation-outcomes and risk factors: the Swiss Transplant Cohort Study	Transplant International			2018	455	0

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