Pre- and post-transplant factors associated with body weight parameters after liver transplantation: A systematic review and meta-analysis

Sonja Beckmann, Gerda Drent, Todd Ruppar, Natasa Nikolic, Sabina De Geest*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    7 Citations (Scopus)
    15 Downloads (Pure)


    Background: Weight gain and obesity can increase liver transplant (LTx) recipients' disease burden. We aimed to summarize and synthesize the evidence on pre- and post-transplant factors related to post-LTx BMI, weight gain, and obesity.

    Methods: For this systematic review and meta-analysis we searched Medline (PubMed), Cochrane library, CINAHL, PsycINFO, and EMBASE for quantitative studies on 6 classes of factors (i.e., genetic, sociodemographic, behavioral, biomedical, psychological, and environmental) linked to body weight parameters in adult first-time LTx patients. A 19-item instrument was used for quality assessment. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for relationships investigated in >= 5 studies. Factors investigated in

    Results: Of 16,495 articles retrieved, 43 assessed factors in LTx. These examined 82 mainly biomedical and sociodemographic factors. However, variation between definitions allowed inclusion of only 2 factors (i.e., tacrolimus, cyclosporine) in our meta-analyses of 6 studies examining a shared parameter for body weight (median patient sample: 171 (range: 63-455); Europe n = 3; United States n = 3; publication years: 1997-2015). Neither tacrolimus (OR, 0.75; 95% CI, 0.47-1.21; p = 0.24) nor cyclosporine (OR, 1.40; 95% CI, 0.89-2.18; p = 0.14) were related significantly with post-LTx obesity.

    Conclusions: Evidence on modifiable factors related to post-LTx body weight parameters is still scarce, as definition variability limits data extraction and pooling for meta-analyses. To facilitate future research, studies should apply theoretical frameworks to guide their study design, select variables of interest and systematically examine interrelationships among selected factors. (C) 2018 Published by Elsevier Inc.

    Original languageEnglish
    Pages (from-to)39-47
    Number of pages9
    JournalTransplantation Reviews
    Issue number1
    Publication statusPublished - Jan-2019


    • Obesity
    • Weight gain
    • Immunosuppressive medication
    • Theoretical framework
    • GAIN

    Cite this