Divergent trajectories of lean vs obese non-alcoholic steatohepatitis patients from listing to post-transplant: A retrospective cohort study

Table 1 Pre-liver transplant clinical and laboratory variables

	Total (n = 176)	BMI groups after ascites correction		P value
		Overweight or obese (n = 122)	Underweight or normal (n = 54)
Age at listing, median (range) years	61.0 (32.0–71.4)	60.3 (32.0–71.4)	61.6 (45.2–71.0)	0.048a
Age at end of listing, median (range) years	61.0 (32.0–72.0)	61.0 (32.0–71.0)	62.0 (48.0–72.0)	0.09
Female sex, n (%)	81 (46.02)	53 (43.44)	28 (51.85)	0.30
Height at listing, median (range) cm	168.0 (148.0–193.0)	168.0 (148.0–188.0)	168.0 (150.0–193.0)	0.23
Weight at listing, median (range) kg	88.3 (39.6–146.5)	94.9 (69.0–146.5)	72.0 (39.6–94.2)	< 0.001c
Ascites adjusted weight at listing, median (range) kg	77.4 (33.7–140.0)	85.1 (60.5–140.0)	64.4 (33.7–80.1)	< 0.001c
Weight at end of listing, median (range) kg	86.9 (39.6–161.8)	92.9 (50.7–161.8)	73.9 (39.6–94.2)	< 0.001c
BMI at listing, median (range) kg/m2	31.0 (17.6–48.9)	33.7 (25.6–48.9)	25.4 (17.6–30.8)	< 0.001c
Ascites adjusted BMI at listing, median (range) kg/m2	27.4 (15.0–45.3)	29.2 (25.0–45.3)	22.6 (15.0–24.9)	< 0.001c
Na MELD (at listing), median (range)	22.0 (10.0–48.0)	21.0 (11.0–48.0)	22.0 (10.0–43.0)	0.34
Na MELD at end of listing, median (range)	23.0 (6.0–45.0)	23.0 (6.0–44.0)	23.0 (10.0–45.0)	0.41
Creatinine at listing, median (range) μmol/L	98.5 (51.0–564.0)	96.5 (55.0–564.0)	103.0 (51.0–399.0)	0.50
Creatinine at end of listing, median (range) μmol/L	112.5 (44.0–719.0)	115.0 (44.0–719.0)	109.0 (49.0–483.0)	0.50
eGFR at listing, median (range) mL/min/1.73 m2	63.0 (17.0–120.0)	65.5 (18.0–117.0)	56.0 (17.0–120.0)	0.11
eGFR at end of listing, median (range) mL/min/1.73 m2	52.5 (17.0–116.0)	57.0 (17.0–116.0)	48.0 (20.0–98.0)	0.017a
Bilirubin at listing, median (range) μmol/L	49.0 (8.0–955.0)	51.0 (8.0–755.0)	45.5 (14.0–955.0)	0.11
Bilirubin at end of listing, median (range) μmol/L	56.5 (3.0–927.0)	58.0 (8.0–927.0)	50.0 (3.0–802.0)	0.19
INR at listing, median (range)	1.5 (1.1–4.7)	1.5 (1.1–4.7)	1.5 (1.1–3.9)	0.05
INR at end of listing, median (range)	1.7 (1.1–7.6)	1.7 (1.1–7.6)	1.8 (1.1–5.0)	0.46
Na at listing, median (range) mEq/L	134.0 (116.0–147.0)	135.0 (120.0–147.0)	133.0 (116.0–142.0)	0.014a
Na at end of listing, median (range) mEq/L	135.0 (116.0–159.0)	135.0 (116.0–159.0)	134.0 (120.0–152.0)	0.10
Albumin at listing, median (range) g/L	30.5 (9.0 – 47.0)	29.5 (20.0–47.0)	31.0 (9.0–42.0)	0.08
Albumin at end of listing, median (range) g/L	30.0 (10.0–54.0)	30.0 (12.0–54.0)	30.0 (10.0–50.0)	0.28
Frailty score (n = 159), median (range)	4.0 (2.0–8.0)	4.0 (2.0–8.0)	5.0 (3.0–8.0)	0.25
None to mild, n (%)	116 (72.96)	78 (71.56)	38 (76)	0.56
Moderate to severe, n (%)	43 (27.04)	31 (28.44)	12 (24)
Missing, n (%)	17 (9.66)	13 (10.66)	4 (7.41)
Encephalopathy, n (%)	141 (80.11)	99 (81.15)	42 (77.78)	0.61
Ascites, n (%)	161 (91.48)	109 (089.34)	052 (096.30)	0.15
Degree of ascites, n (%)
None	14 (07.95)	13 (10.66)	1 (1.85)	0.030a
Mild	41 (23.30)	30 (24.59)	11 (20.37)
Moderate	30 (17.05)	24 (019.67)	6 (11.11)
Severe	91 (51.70)	55 (45.08)	36 (66.67)
Need for LVP, n (%)	103 (58.86)	64 (52.89)	39 (72.22)	0.016a
SBP, n (%)	46 (26.44)	33 (27.05)	13 (25.00)	0.78
Variceal bleed, n (%)	53 (30.11)	34 (27.87)	19 (35.19)	0.33
Hepatorenal syndrome, n (%)	48 (27.27)	30 (24.59)	18 (33.33)	0.23
Hypertension, n (%)	80 (45.45)	58 (47.54)	22 (40.74)	0.40
Diabetes, n (%)	104 (59.09)	68 (55.74)	36 (66.67)	0.17
Hyperlipidemia, n (%)	57 (32.39)	35 (28.69)	22 (40.74)	0.12
CKD, n (%)	18 (10.23)	12 (9.84)	6 (11.11)	0.80
CAD, n (%)	29 (16.48)	22 (18.03)	7 (12.96)	0.40
Time on waiting list, median (range) days	136.0 (1.0–1566.0)	139.5 (1.0–1497.0)	117.0 (1.0–1566.0)	0.42
ICU stay within 90 d before end of listing, n (%)	30 (17.05)	21 (17.21)	9 (16.67)	0.93
No of hospitalizations within 90 d before end of listing, median (range), n (%)	1.0 (0.0–5.0)	1.0 (0.0–5.0)	1.0 (0.0–5.0)	0.42
< 2	151 (85.80)	105 (86.07)	46 (85.19)	0.88
≥ 2	25 (14.20)	17 (13.93)	8 (14.81)
Bacteraemia/sepsis within 90 d before end of listing, n (%)	19 (11.66)	12 (10.62)	7 (14.00)	0.54
Outcome, n (%)
Active living	1 (0.57)	1 (0.82)	0 (00)	0.26
De-listed	22 (12.50)	14 (11.48)	8 (14.81)
Died	42 (23.86)	25 (20.49)	17 (31.48)
Transplanted	111 (63.07)	82 (67.21)	29 (53.70)
Type of LT received, n (%)
DDLT	78 (70.27)	57 (69.51)	21 (72.41)	0.77
LDLT	33 (29.73)	25 (30.49)	8 (27.59)

^aP < 0.05.

^cP < 0.001.

BMI: Body mass index; CAD: Coronary artery disease; CKD: Chronic kidney disease; DDLT: Deceased donor liver transplant; eGFR: Estimated glomerular filtration rate; ICU: Intensive care unit; INR: International normalized ratio; LT: Liver transplant; LDLT: Living donor liver transplant; LVP: Large volume paracentesis; MELD: Model for end stage liver disease; Na: Sodium; SBP: Spontaneous bacterial peritonitis.