Obese Fare Well After Heart Transplant

April 11, 2008 (Boston) -- Heart transplant recipients who are obese or even extremely obese at the time of surgery seem to do just as well as lean heart transplant patients, said researchers at a heart and lung transplant meeting here.

In a study of 430 patients who underwent a heart transplant at Temple University Hospital in Philadelphia over a 10-year period, there were no major differences in survival rates among patients with lean, moderately obese, or extremely obese bodies, says Abul Kashem, MD, PhD.

The researchers looked at records on all patients who underwent a heart transplant at their center from 1992 through 2002. They divided the patients into three groups according to BMI: less than 31 (normal to moderately overweight; 367 patients), 31-35 (obese; 52 patients) and greater than 35 (extremely obese; 11 patients).

Survival Rates and Weight

When they looked at survival by weight they found that the leanest group of patients had 91% survival in the first month after surgery, compared with 88% for those in the 31-35 BMI category, and 81% in those with BMIs of 36 and up. There was a slight decline in survival rates after one year among the extremely obese patients, but the survival rate stayed steady after that and remained so out to 10 years, Kashem says. Furthermore, BMI was not associated with need for additional surgery, post-surgery infections, or length of stay. 

When they analyzed the data according to other risk factors, they found that age of the organ recipient and the organ donor, female gender, organ-preservation time before transplantation, kidney function, and high blood pressure were each separately associated with the likelihood of survival.

"Our results show BMI was not an independent risk factor for mortality in this study, and no level of BMI led to significantly worse survival," Kashem says. "Obesity should not be a contraindication to transplantation."

Kashem acknowledges that the study was limited by the relatively small numbers of patients in the two obesity categories, and by the fact that they did not consider weight change among patients from the beginning of the study to other study time points. 

The study was presented at the 28th annual meeting and scientific sessions of the International Society for Heart and Lung Transplantation.