A matched pair analysis of multicenter longterm follow-up after split-liver transplantation with extended right grafts

Split-liver transplantation has been proposed as an alternative to whole liver (WL) transplantation to expand the donor pool, but studies comparing adult longterm outcomes between the 2 methods are conflicting and limited. This is the first Italian multicenter study that retrospectively analyzed 119 matched-pair recipients of whole and extended right grafts (ERGs) for longterm survival outcomes. In the overall population, WL recipients showed higher patient survival at 1 (93% versus 73%), 5 (87% versus 65%), and 10 years (83% versus 60%) after transplantation compared with split-liver recipients (P< 0.001); graft survivals of WL recipients were also superior at 1 (90% versus 76%), 5 (84% versus 57%), and 10 years (81% versus 52%) posttransplant (P < 0.001). However, among the 81 matched pairs that survived the first posttransplant year, 5-and 10-year patient survivals were 90% and 81% for split recipients and 99% and 96% for whole recipients, respectively (P50.34). The 5-and 10-year graft survivals were also comparable: 87% and 77% for split recipients, and 86% and 82% for whole recipients (P50.86). Cox regression analysis identified donor age > 50, donor-to-recipient weight ratio< 1, retransplantation status, and United Network for Organ Sharing I-IIA status as risk factors for partial graft use. There were no significant differences in 5-year outcomes based on center volume. In conclusion, we demonstrate that adult liver transplantation with ERGs can achieve longterm success comparable with that of whole grafts in appropriate patients but should be selectively used in patients with risk factors

Underestimation of weight and its associated factors in overweight and obese university students from 21 low, middle and emerging economy countries

Awareness of overweight status is an important factor of weight control and may have more impact on one?s decision to lose weight than objective weight status. The purpose of this study was to assess the prevalence of underestimation of overweight/obesity and its associated factors among university students from 21 low, middle and emerging economy countries. In a cross-sectional survey the total sample included 15,068 undergraduate university students (mean age 20.8, SD = 2.8, age range of 16-30 years) from 21 countries. Anthropometric measurements and self-administrated questionnaire were applied to collected data. The prevalence of weight underestimation (being normal or underweight) for overweight or obese university students was 33.3% (41% in men and 25.1% in women), among overweight students, 39% felt they had normal weight or were under weight, and among obese students 67% did not rate themselves as obese or very overweight. In multivariate logistic regression analysis, being male, poor subjective health status, lack of overweight health risk awareness, lack of importance to lose weight, not trying and not dieting to lose weight, and regularbreakfast was associated with underestimation of weight in overweight and obeseuniversity students.Conclusions: The study found a high prevalence of underestimation of over-weight/obesity among university students. Several factors identified can be utilized inhealth promotion programmes including diet and weight management behaviours tofocus on inaccurate weight perceptions on the design of weight control, in particularfor men.