Losing weight can reduce risk of death, ventilator use in lung transplant patients

In the manuscript, "Weight loss prior to lung transplantation is associated with improved survival," Mayo Clinic researchers showed that a one unit reduction in body mass index in overweight and obese lung transplant recipients resulted in a reduced risk of death. The study also showed overweight and obese patients who lost weight spent less time on a mechanical ventilator after transplantation surgery.

"We knew from past research that obesity complicates post-transplant outcomes and survival," says Cassie Kennedy, M.D., Mayo Clinic pulmonologist and transplant researcher. "Many practices advocated delaying transplant listing for obese patients to allow for weight loss, but we didn't know if losing weight prior to transplantation was realistic. Patients awaiting lung transplantation have functional limitations that might impede weight loss. We also did not know if weight loss before lung transplant could actually help transplant patients live longer and avoid complications. This study showed weight loss in overweight and obese patients was achievable, sustained six to 12 months post-surgery, and that these individuals had improved survival and fewer complications related to their transplant procedure."

The study examined 341 patients who had received a lung transplant at Mayo Clinic, Rochester, Minnesota, or Mayo Clinic, Jacksonville, Florida, between January 2000 and November 2010. The average patient age was 59 years and more than half (55 percent) of patients were male. According to Dr. Kennedy, 64 percent of patients were able to lose weight and did so, on average, in the nine months prior to their transplantation. Six months post-procedure, weight loss was maintained in overweight and obese patients, and 12 months post-procedure, the average weight gain was only 3.5 pounds.

"We found that, not only is it reasonable for lung transplant patients to lose weight before surgery, but it is also reasonable to expect they can sustain that loss after transplantation and improve their long-term outlook," says Dr. Kennedy. "This knowledge is significant as we're seeing increases in the percentage of people who are overweight or obese, and as the need for transplant procedures continues to climb. Improving outcomes by managing weight provides a meaningful benefit to patients, and improves the stewardship of the donor organs."