{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:39:32Z","timestamp":1791261572502,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Gen Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>While the effect of pre-transplant weight on patient outcomes following heart transplantation (HTx) has previously been studied, data regarding the impact of dynamic weight change prior to HTx are extremely limited.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>We sought to elucidate the interaction between HTx listing weight and weight change while waitlisted, and explore how that interaction impacts post-HTx survival in a continuous manner.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Adult patients listed for HTx from 1987 to 2020 were identified from UNOS database. Three-dimensional restricted cubic spline analysis explored post-HTx survival relative to both changes in BMI\/weight and BMI at time of HTx listing. Continuous predictor variables were analyzed with Cox proportional hazards method.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>9,628 included patients underwent HTx. Median recipient age was 55 [IQR 46\u201362] years, and 21% were females. 53% of patients lost while 47% gained weight on the waitlist. Median BMI (27.6\u00a0kg\/m<jats:sup>2<\/jats:sup> [24.3\u201331.3] vs. 27.4\u00a0kg\/m<jats:sup>2<\/jats:sup> [24.2\u201330.9], paired <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and weight (84.8\u00a0kg [73.0\u201398.0] kg vs. 84.4\u00a0kg [72.6\u201396.6], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were similar at listing and transplant. One-year survival was 89.3%. Weight loss over 3 BMI points or 10\u00a0kg was associated with higher hazard of death irrespective of listing BMI. In non-obese patients, some weight gain (1\u20134 BMI points or 5\u201315\u00a0kg) was associated with improved survival. In cachectic patients (BMI\u2009&lt;\u200918.5), failure to gain weight was associated with worse survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Impact of weight change varies depending on listing BMI. While a survival benefit is seen in non-obese patients who gain some weight, significant weight loss is associated with poorer survival.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11748-024-02078-y","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T11:02:27Z","timestamp":1727953347000},"page":"336-342","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of waitlist weight change on outcomes in heart transplant recipients: a UNOS database analysis"],"prefix":"10.1007","volume":"73","author":[{"given":"Melissa A.","family":"Austin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danial","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake L.","family":"Rosen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P.","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indranee","family":"Rajapreyar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus Eduardo","family":"Rame","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene J.","family":"Alvarez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Entwistle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard T.","family":"Massey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vakhtang","family":"Tchantchaleishvili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,3]]},"reference":[{"key":"2078_CR1","unstructured":"Current U.S. Waiting List; Overall by Organ. Organ Procurement and Transplantation Network. https:\/\/optn.transplant.hrsa.gov\/data\/view-data-reports\/national-data\/#. Published 2022. Accessed 1 Mar 2022."},{"key":"2078_CR2","unstructured":"Heart Competing Risk Median Waiting Time to Deceased Donor Transplant For Registrations Listed: 2003-2014tle. Organ Procurement and Transplantation Network. https:\/\/optn.transplant.hrsa.gov\/data\/view-data-reports\/national-data\/#. Published 2022. Accessed 1 Mar 2022."},{"issue":"1","key":"2078_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.healun.2015.10.023","volume":"35","author":"MR Mehra","year":"2016","unstructured":"Mehra MR, Canter CE, Hannan MM, et al. The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: a 10-year update. J Hear Lung Transplant. 2016;35(1):1\u201323. https:\/\/doi.org\/10.1016\/j.healun.2015.10.023.","journal-title":"J Hear Lung Transplant"},{"issue":"1","key":"2078_CR4","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1097\/SLA.0b013e3181b5db3c","volume":"251","author":"MJ Russo","year":"2010","unstructured":"Russo MJ, Hong KN, Davies RR, et al. The effect of body mass index on survival following heart transplantation: do outcomes support consensus guidelines? Ann Surg. 2010;251(1):144\u201352. https:\/\/doi.org\/10.1097\/SLA.0b013e3181b5db3c.","journal-title":"Ann Surg"},{"issue":"23","key":"2078_CR5","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021346","volume":"10","author":"F Chouairi","year":"2021","unstructured":"Chouairi F, Milner A, Sen S, et al. Impact of obesity on heart transplantation outcomes. J Am Heart Assoc. 2021;10(23): e021346. https:\/\/doi.org\/10.1161\/JAHA.121.021346.","journal-title":"J Am Heart Assoc"},{"key":"2078_CR6","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.amjcard.2020.12.084","volume":"145","author":"BW Fisher","year":"2021","unstructured":"Fisher BW, Huckaby LV, Sultan I, Hickey G, Kilic A. Center-level variations in maximum recipient body mass index in heart transplantation. Am J Cardiol. 2021;145:91\u20136. https:\/\/doi.org\/10.1016\/j.amjcard.2020.12.084.","journal-title":"Am J Cardiol"},{"issue":"7","key":"2078_CR7","doi-asserted-by":"publisher","first-page":"e13621","DOI":"10.1111\/ctr.13621","volume":"33","author":"BS Doumouras","year":"2019","unstructured":"Doumouras BS, Fan CPS, Mueller B, et al. The effect of pre\u2013heart transplant body mass index on posttransplant outcomes: an analysis of the ISHLT Registry Data. Clin Transplant. 2019;33(7):e13621. https:\/\/doi.org\/10.1111\/ctr.13621.","journal-title":"Clin Transplant"},{"issue":"3","key":"2078_CR8","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1007\/s11695-015-1789-1","volume":"26","author":"CP Lim","year":"2016","unstructured":"Lim CP, Fisher OM, Falkenback D, et al. Bariatric surgery provides a \u201cbridge to transplant\u201d for morbidly obese patients with advanced heart failure and may obviate the need for transplantation. Obes Surg. 2016;26(3):486\u201393. https:\/\/doi.org\/10.1007\/s11695-015-1789-1.","journal-title":"Obes Surg"},{"issue":"2","key":"2078_CR9","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1111\/jocs.12688","volume":"31","author":"EI Jeng","year":"2016","unstructured":"Jeng EI, Aranda JM Jr, Ahmed M, Klodell CT. Left ventricular assist device and bariatric surgery: a bridge to heart transplant by weight and waiting time reduction. J Card Surg. 2016;31(2):120\u20132. https:\/\/doi.org\/10.1111\/jocs.12688.","journal-title":"J Card Surg"},{"issue":"21","key":"2078_CR10","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.1093\/eurheartj\/ehn420","volume":"29","author":"SJ Pocock","year":"2008","unstructured":"Pocock SJ, McMurray JJ, Dobson J, et al. Weight loss and mortality risk in patients with chronic heart failure in the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) programme. Eur Heart J. 2008;29(21):2641\u201350. https:\/\/doi.org\/10.1093\/eurheartj\/ehn420.","journal-title":"Eur Heart J"},{"issue":"3","key":"2078_CR11","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002468","volume":"5","author":"E Zamora","year":"2016","unstructured":"Zamora E, D\u00edez-L\u00f3pez C, Lup\u00f3n J, et al. Weight loss in obese patients with heart failure. J Am Coll Cardiol. 2016;5(3): e002468. https:\/\/doi.org\/10.1161\/JAHA.115.002468.","journal-title":"J Am Coll Cardiol"},{"issue":"7549","key":"2078_CR12","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1136\/bmj.332.7549.1080","volume":"332","author":"DG Altman","year":"2006","unstructured":"Altman DG, Royston P. The cost of dichotomising continuous variables. BMJ. 2006;332(7549):1080. https:\/\/doi.org\/10.1136\/bmj.332.7549.1080.","journal-title":"BMJ"},{"issue":"19","key":"2078_CR13","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.1002\/sim.4780141906","volume":"14","author":"JE Herndon","year":"1995","unstructured":"Herndon JE, Harrel FE. The restricted cubic spline as baseline hazard in the proportional hazards model with step function time-dependent covariables. Stat Med. 1995;14(19):2119\u201329. https:\/\/doi.org\/10.1002\/sim.4780141906.","journal-title":"Stat Med"},{"key":"2078_CR14","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/978-1-4612-1694-0_16","volume-title":"Selected papers of Hirotugu Akaike","author":"H Akaike","year":"1974","unstructured":"Akaike H. A new look at the statistical model identification. In: Parzen E, Tanabe KKG, editors. Selected papers of Hirotugu Akaike. New York: Springer; 1974. p. 215\u201322. https:\/\/doi.org\/10.1007\/978-1-4612-1694-0_16."},{"key":"2078_CR15","doi-asserted-by":"crossref","unstructured":"Harrell FE. Regression Modeling Strategies. https:\/\/cran.r-project.org\/web\/packages\/rms\/rms.pdf. Published 2021.","DOI":"10.32614\/CRAN.package.rmsb"},{"issue":"3","key":"2078_CR16","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1093\/ndt\/gfab164","volume":"74","author":"MN Harhay","year":"2019","unstructured":"Harhay MN, Ranganna K, Boyle SM, et al. Association between weight loss before deceased donor kidney transplantation and posttransplantation outcomes. Am J Kidney Dis. 2019;74(3):361\u201372. https:\/\/doi.org\/10.1093\/ndt\/gfab164.","journal-title":"Am J Kidney Dis"},{"issue":"10","key":"2078_CR17","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1093\/ndt\/gfab164","volume":"36","author":"MN Harhay","year":"2021","unstructured":"Harhay MN, Chen X, Chu NM, Norman SP, Segev DL, McAdams-DeMarco M. Pre-kidney transplant unintentional weight loss leads to worse post-kidney transplant outcomes. Nephrol Dial Transplant. 2021;36(10):1927\u201336. https:\/\/doi.org\/10.1093\/ndt\/gfab164.","journal-title":"Nephrol Dial Transplant"},{"issue":"5","key":"2078_CR18","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/j.healun.2014.11.018","volume":"34","author":"S Chandrashekaran","year":"2015","unstructured":"Chandrashekaran S, Keller CA, Kremers WK, Peters SG, Hathcock MA, Kennedy CC. Weight loss prior to lung transplantation is associated with improved survival. J Hear Lung Transplant. 2015;34(5):651\u20137. https:\/\/doi.org\/10.1016\/j.healun.2014.11.018.","journal-title":"J Hear Lung Transplant"},{"issue":"12","key":"2078_CR19","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1016\/j.healun.2018.07.015","volume":"37","author":"ES Clausen","year":"2018","unstructured":"Clausen ES, Frankel C, Palmer SM, Snyder LD, Smith PJ. Pre-transplant weight loss and clinical outcomes after lung transplantation. J Hear Lung Transplant. 2018;37(12):1443\u20137. https:\/\/doi.org\/10.1016\/j.healun.2018.07.015.","journal-title":"J Hear Lung Transplant"},{"issue":"4","key":"2078_CR20","doi-asserted-by":"publisher","first-page":"S251","DOI":"10.1016\/j.healun.2021.01.715","volume":"40","author":"NR Hess","year":"2021","unstructured":"Hess NR, Hickey GW, Sultan I, Kolic A. Waitlist weight changes impact survival following heart transplantation [ISHLT Abstract 600]. J Hear Lung Transplant. 2021;40(4):S251.","journal-title":"J Hear Lung Transplant"},{"key":"2078_CR21","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1016\/S0735-1097(01)01448-6","volume":"38","author":"TB Horwich","year":"2001","unstructured":"Horwich TB, Fonarow GC, Hamilton MA, et al. The relationship between obesity and mortality in patients with heart failure. J Am Coll Cardiol. 2001;38:789\u201395.","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"2078_CR22","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.ahj.2006.09.007","volume":"153","author":"GC Fonarow","year":"2007","unstructured":"Fonarow GC, Srikanthan P, Costanzo MR, Cintron GB, Lopatin M. An obesity paradox in acute heart failure: analysis of body mass index and in hospital mortality for 108,927 patients in the acute decompensated heart failure National Registry. Am Heart J. 2007;153(1):74\u201381. https:\/\/doi.org\/10.1016\/j.ahj.2006.09.007.","journal-title":"Am Heart J"},{"issue":"21","key":"2078_CR23","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1016\/j.jacc.2008.12.068","volume":"53","author":"CJ Lavie","year":"2009","unstructured":"Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53(21):1925\u201332. https:\/\/doi.org\/10.1016\/j.jacc.2008.12.068.","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"2078_CR24","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1093\/bja\/85.1.109","volume":"85","author":"JP Desborough","year":"2000","unstructured":"Desborough JP. The stress response to trauma and surgery. Br J Anaesth. 2000;85(1):109\u201317. https:\/\/doi.org\/10.1093\/bja\/85.1.109.","journal-title":"Br J Anaesth"},{"issue":"3","key":"2078_CR25","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.pharmthera.2008.09.009","volume":"121","author":"S von Haehling","year":"2009","unstructured":"von Haehling S, Lainscak M, Springer J, Anker SD. Cardiac cachexia: a systematic overview. Pharmacol Ther Pharmacol Ther. 2009;121(3):221\u201352. https:\/\/doi.org\/10.1016\/j.pharmthera.2008.09.009.","journal-title":"Pharmacol Ther Pharmacol Ther"}],"container-title":["General Thoracic and Cardiovascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11748-024-02078-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11748-024-02078-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11748-024-02078-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T08:59:51Z","timestamp":1744448391000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11748-024-02078-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,3]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["2078"],"URL":"https:\/\/doi.org\/10.1007\/s11748-024-02078-y","relation":{},"ISSN":["1863-6705","1863-6713"],"issn-type":[{"value":"1863-6705","type":"print"},{"value":"1863-6713","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,3]]},"assertion":[{"value":"26 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 October 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None of the authors have any conflicts to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}