THURSDAY, Aug. 6 (HealthDay News) -- Underweight and extremely obese liver transplant patients are at higher risk of death than patients with less extreme weights, according to a study in the August issue of Liver Transplantation.

Andre A.S. Dick, M.D., and colleagues from the University of Washington in Seattle reviewed morbidity and mortality data based on body mass index in 73,538 adults who underwent liver transplantation between 1987 and 2007. Patients were categorized as underweight, normal weight, overweight, obese, severely obese, or very severely obese.

After adjusting for other variables, the researchers found that survival was significantly lower in underweight (relative risk, 1.14 to 1.73, depending on time period) and very severely obese patients (relative risk, 1.07 to 1.41, depending on time period) compared with all the other groups. Underweight patients were significantly more likely to die of hemorrhagic complications and cerebrovascular accidents, while very severely obese patients were significantly more likely to die of infectious complications and cancer.

"In conclusion, liver transplantation holds increased risk for patients at the extremes of body mass index," Dick and colleagues write. "Identifying these patients and instituting aggressive new policies may improve outcomes."

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