Background/Aims: Excessive weight gain is increasingly common after liver transplantation as is the prevalence of cardiovascular risk factors, leading to increased CVD morbidity and mortality. Currently there is no Australian data published or evidence based practice guidelines for excessive weight gain or obesity in this patient group. The aim was to characterise weight and cardiovascular risk factor profiles of adult’s pre and post-liver transplantation.
Methods: A retrospective case note audit of 171 adults who received a orthotopic liver transplantation, between 1992-2011 at Flinders Medical Centre in Adelaide, South Australia. Anthropometric, socio-demographic and clinical data were collected pre-transplant, 4-months, and 12-months post-transplant and yearly thereafter for five years. The proportion of participants with risk factors pre and post-transplant were compared and predictors of post-transplant weight gain were assessed.
Results: Weight significantly increased from 4-months to 5-years after transplantation (p<0.001), with the greatest increase of 5.3kg (7%) occurring between 4-months and 1-year post-transplant. Pre-transplant the prevalence of dyslipidaemia was 61%, hypertension 35%, diabetes 33%, and obesity 26%. Compared with pre-transplant, a significantly greater proportion of the sample presented with hypertension (62%), diabetes (47%) and obesity (43%) within 5-years post-transplant (p<0.05). Patients’ age, pre-transplant obesity and use of immunosuppressant medications were significant predictors of weight gain post-transplant.
Conclusion: Rapid weight gain tends to occur between 4-months and 1-years post-transplant. A focus on preventing excessive weight gain pre and post-transplant may have a clinically significant impact on decreasing the risk of obesity and cardiovascular related morbidity and mortality.
Funding source(s): Nil