Effect of Body Mass Index on Complications and Survival After Living Donor Liver Transplantation.

Cohort studyExperimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation· May 2026

Effect of Body Mass Index on Complications and Survival After Living Donor Liver Transplantation.

Birkan Birben, Gurkan Degirmencioglu, Deniz Kutuk … Abuzer Dirican

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Transplant SurgeryCohort studyPrognosisQ3IF 0.7

Obesity independently linked to lower long-term survival after living donor liver transplant

Effect of Body Mass Index on Complications and Survival After Living Donor Liver Transplantation.

Birkan Birben … Abuzer Dirican

Experimental and clinical transplantation · May 2026

Purpose

The influence of obesity on postoperative outcomes remains controversial.

Methods

We retrospectively studied 225 adult patients who underwent living donor liver transplant between November 2019 and June 2024 and grouped patients by preoperative body mass index (calculated as weight in kilograms divided by height in meters squared) into 4 groups.

n = 225 adult

Results

obesity raised the risk of death long after transplant

HR 1.65 (95% CI 1.01 to 2.70)

null 1

1.01

2.70

CI excludes the null - significant

More results

Although Model for End-Stage Liver Disease scores, operative time, and hospital stay did not differ significantly among groups, higher body mass index was associated with significantly increased early postoperative complications (P = .018).

More results

Logistic regression revealed early complications as an independent predictor of mortality (odds ratio of ≈9, P < .001).

Overall survival differed significantly across body mass index categories (P = .007), with poorest outcomes in morbidly obese patients (body mass index ≥ 40).

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Conclusion · 1 of 3

Elevated body mass index was associated with increased early postoperative risk, particularly in the obese group, with reduced long-term survival posttransplant.

Conclusion · 2 of 3

These associations remained significant after adjustment for major clinical covariates. Presence of comorbidities and reduced graft-to-recipient weight ratio further compounded risk.

Conclusion · 3 of 3

Comprehensive preoperative evaluation and individualized management, including metabolic optimization and prehabilitation, may help improve outcomes in this high-risk population.

Effect of Body Mass Index on Complications and Survival After Living Donor Liver Transplantation.

Effect of Body Mass Index on Complications and Survival After Living Donor Liver Transplantation.

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