Regional Variation in Utilization and Outcomes of Liver Allografts from Donors with High Body-Mass Index and Graft Macrosteatosis: A Role for Liver Biopsy

Background Obesity, defined as a body mass index ≥30 kg/m2 (hBMI), is a growing epidemic worldwide and is associated with multiple comorbidities. hBMI individuals account for an increasing portion of potential liver donors. Here we evaluate trends in the utilization and outcomes of hBMI donors on a national and regional level and the potential role of liver biopsy in donor evaluation. Methods UNOS STAR database was evaluated for deceased donor liver transplants between 2006 and 2016 across 11 OPTN regions. hBMI donors were compared to lower BMI counterparts and evaluated for biopsy rates, utilization rates and allograft outcomes. Univariate and multivariable analyses were performed. Results 77 050 potential donors were identified and 60 200 transplants were evaluated. Utilization rates for hBMI donors was 66.1% versus 78.1% for lower BMI donors (p

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