Study objectives: The purpose of this study was to
determine the impact of a pretransplantation determination of body mass
index (BMI) on survival after lung transplantation.
and patients: Univariate and multivariate survival analyses of a
single institution database consisting of 85 patients who had undergone
lung transplantations between March 1994 and October 1998.
Setting: University of Florida Health Science Center.
Results: Kaplan-Meier survival curves showed that patients
who were obese (ie, BMI, ≥ 30) at a pretransplantation
assessment had a marked decrease in posttransplantation survival time
(log rank, p < 0.05; Wilcoxon, p < 0.05). The final Cox
regression model revealed that the most powerful predictors of
mortality after lung transplantation were higher pretransplantation BMI
and the development of obliterative bronchiolitis.
Conclusions: Our results suggest that the
posttransplantation risk for mortality is possibly three times greater
for obese patients than for nonobese patients. Additional study is
needed to identify the mechanisms for such higher risk in obese
patients. Our data also suggest that transplantation centers should not
routinely reject underweight patients (ie, BMI,< 18.5) or overweight patients (ie, BMI, 25 to 29.9)
for lung transplantation listing solely on the basis of weight, as
their outcomes may not be significantly different than patients with