The negative effect of pretransplant overweight and obesity on the rate of improvement in physical quality of life after liver transplantation

Background. Recent studies suggest that obesity does not affect survival after liver transplantation. Overweight and obesity, however, impair health-related quality of life (HRQOL) in patients with chronic illnesses. We tested the effect of pretransplant body weight on HRQOL in liver transplant recipients. Methods. Prospective, longitudinal HRQOL data were collected using the SF-36 health survey. Pretransplant body weight was stratified based on body mass index (BMI), as follows: normal (18.5-24.9), overweight (25.0-29.9), and obese (>= 30.0). Linear mixed-effects models were used to test the effects Pretransplant BMI category on the trajectory of HRQOL after liver transplantation. Results. The sample included 154 adults who underwent liver transplantation. Thirty-one percent had normal BMI, 41% were overweight, and 28% were obese pretransplant. The mean pretransplant physical HRQOL did not differ 1, BMI group (P >= .697). Physical and mental HRQOL improved (P < .001) in all groups after transplantation, but the rate of improvement in physical HRQOL was significantly greater during the first year posttransplant in the normal BMI compared with the overweight and obese patients (P <= .032). There was no effect of BMI on the rate of improvement in menial HRQOL. Conclusion. Excess pretransplant body weight hinders the rate of improvement in physical quality of life during the first year after liver transplantation. (Surgery 2009,146:174-80.)