The Impact of Waiting List Bmi Changes on the Short-Term Outcomes of Lung Transplantation.

Background: Obesity and underweight are associated with a higher postlung transplantation (LTx) mortality. This study aims to assess the impact of the changes in BMI during the waiting period for LTx on early postoperative outcomes. Methods: Medical records of 502 consecutive cases of LTx performed at our institution between 1999 and 2015 were reviewed. Patients were stratified per change in BMI category between pre-LTx assessment (candidate BMI) and transplant BMI as follows: A-Candidate BMI=30 and Transplant BMI18.5-29.9 and E-Candidate BMI>=30 or 18.5-29.9 and Transplant BMI>=30. Our primary outcome was in-hospital (H) mortality and secondary outcomes were length of mechanical ventilation (MV), intensive care unit (ICU) length of stay (LOS), H LOS and postoperative complications. Results: BMI variation during the waiting time was common, as 1/3 of patients experienced a change in BMI category. Length of MV (21 vs. 9 d; p=0.018), ICU LOS (26 vs. 15 d; p=0.035) and rates of surgical complications (76 vs. 44%; p=0.018) were significantly worse in patients of group E vs. D. Obese candidates who failed to decrease BMI

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