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Severely Obese Heart Donors Not Tied to Adverse Transplant Outcomes

Short-term outcomes for recipients similar for heart transplants from donors with, without severe obesity

WEDNESDAY, Sept. 16, 2020 (HealthDay News) -- Severe obesity in organ donors is not associated with adverse heart transplant outcomes, according to a study published online Sept. 16 in Circulation: Heart Failure.

Elizabeth D. Krebs, M.D., from the University of Virginia Health System in Charlottesville, and colleagues stratified single-organ first-time adult heart transplants from 2003 to 2017 from the United Network for Organ Sharing database by donor severe obesity status (body mass index [BMI], ≥40 kg/m²). The association between severe obesity and outcomes was assessed.

The researchers found that 3.5 percent of the 26,532 donors had a BMI ≥40 kg/m², with prevalence increasing over time (2.2 and 5.3 percent in 2003 and 2017, respectively). Severely obese donors more often had diabetes mellitus and hypertension; 67.4 percent were size-mismatched (donor weight >130 percent of recipient). Similar short-term outcomes were seen, including one-year survival (10.6 versus 10.7 percent); unadjusted and risk-adjusted long-term survival were not significantly different (hazard ratio, 0.928). Over time, there was an increase in severe obesity in the pool of organ donation candidates, from 3.5 to 6.8 percent in 2003 to 2017, with a lower proportion of hearts from severely obese donors transplanted (19.5 versus 31.6 percent of donors without severe obesity).

"Given the continued increase in obesity in the United States, this research has the potential to expand the critically low donor pool by increasing the number of donors and improving outcomes for the growing list of patients with end-stage heart failure," a coauthor said in a statement.

One author disclosed financial ties to the pharmaceutical and medical device industries.

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