Severe obesity increases risk of graft loss in pediatric heart transplantation
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objectives: Severe obesity is an established risk factor for adverse cardiovascular events and heart transplantation (HT) outcomes in adults. However, the effect of severe obesity on children after HT is not well studied. We aimed to examine the prevalence and effect of severe obesity on pediatric HT. Methods: We evaluated children (>8 years) listed for HT using the United Network for Organ Sharing database. Severe obesity was defined per Centers for Disease Control and Prevention criteria using body mass index. Our study comprised 2 groups: a severe obesity group (n = 212, 8%) and a control group (n = 2417, 92%) consisting of the remaining children. We compared characteristics and outcomes between the 2 groups. Results: = .0003), along with age, gender, race, congenital heart disease, creatinine, extracorporeal membrane oxygenation, and donor age. Conclusions: There is a pressing need to improve assessment and treatment of obesity in children with end-stage heart failure awaiting transplantation. Although early survival rates are comparable, med- and long-term outcomes are concerning for severely obese children after heart transplant. Though unclear, the pathophysiologic effects are likely due to accelerated allograft vasculopathy from the metabolic derangement of obesity. Particularly in older children and adolescents, severe obesity should be considered a modifiable risk factor and aggressively managed before and after transplantation.
Source: JTCVS Open
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,431
OpenAlex ID: W4410495234