{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:09:47Z","timestamp":1792465787137,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Liver transplant (LT) candidates with a body mass index (BMI) over 40\u00a0kg\/m<jats:sup>2<\/jats:sup> have lower access to a liver graft without clear explanation. Thus, we studied the impact of obesity on the waiting list (WL) and aimed to explore graft proposals and refusal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data between January 2007 and December 2017 were extracted from the French prospective national database: CRISTAL. Competing risk analyses were performed to evaluate predictors of receiving LT. Competitive events were (1) death\/WL removal for disease aggravation or (2) improvement. The link between grade obesity, grafts propositions, and reason for refusal was studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>15,184 patients were analysed: 10,813 transplant, 2847 death\/dropout for aggravation, 748 redirected for improvement, and 776 censored. Mortality\/dropout were higher in BMI over 35 (18% vs. 14% 1\u00a0year after listing) than in other candidates. In multivariate analysis, BMI&gt;35, age, hepatic encephalopathy, and ascites were independent predictors of death\/dropout. Candidates with a BMI \u2265 35\u00a0kg\/m<jats:sup>2<\/jats:sup> had reduced access to LT, without differences in graft proposals. However, grafts refusal was more frequent especially for \u2018morphological incompatibility\u2019 (14.9% vs. 12.7% <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BMI over 35\u00a0kg\/m<jats:sup>2<\/jats:sup> reduces access to LT with increased risk of dropout and mortality. Increased mortality and dropout could be due to a lower access to liver graft secondary to increased graft refusal for morphological incompatibility.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12226","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T09:44:34Z","timestamp":1650966274000},"page":"396-408","source":"Crossref","is-referenced-by-count":17,"title":["Morbid obesity increases death and dropout from the liver transplantation waiting list: A prospective cohort study"],"prefix":"10.1002","volume":"10","author":[{"given":"Claire","family":"Delac\u00f4te","sequence":"first","affiliation":[{"name":"INSERM U1286 INFINTE Institute for Translational Research in Inflammation University Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Favre","sequence":"additional","affiliation":[{"name":"Service des maladies de l'appareil, digestif University Lille, CHU de Lille  Lille 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