Effect of Pre-Transplant Recipient Underweight on the Postoperative Outcome and Graft Survival in Primary Kidney Transplantation

Rademacher, Sebastian; Brunotte, Maximilian; Wichmann, Yrjö; Kaths, J. Moritz; Seehofer, Daniel; Sucher, Robert; Scheuermann, Uwe

doi:10.1016/j.transproceed.2023.04.038

Cited by 2 publications

(5 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This aligns with the findings in other types of surgery but has not been shown conclusively in kidney transplantation. 16,22 The "obesity paradox" has previously been described in other surgical specialties and underlines that both being underweight and morbidly obese (BMI >40) is a risk factor for complications, whereas patients with class 1 or 2 obesity seem at equal or even lower risk of complications compared with normal weight. 23 Malnutrition is common in patients with end-stage renal disease, 24 and this may lead to metabolic dysfunction when the body is exposed to the stress of surgery.…”

Section: Discussionmentioning

confidence: 98%

“…5,12-15 Underweight (BMI <18.5) has been shown to affect long-term graft survival but has not conclusively shown to affect postoperative complications in kidney transplantation. 16…”

mentioning

confidence: 99%

“…5,[12][13][14][15] Underweight (BMI <18.5) has been shown to affect long-term graft survival but has not conclusively shown to affect postoperative complications in kidney transplantation. 16 The conflicting results and heterogeneous reporting of complications call for further studies of overall surgical complications and the identification of modifiable risk factors. Therefore, this study aims to systematically describe and identify postoperative short-term and long-term complications after RTx in a large institutional cohort and identify risk factors for a complicated surgical course.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Surgical Complications Following Renal Transplantation in a Large Institutional Cohort

Dagnæs-Hansen,

Kristensen,

Stroomberg

et al. 2024

Transplantation Direct

View full text Add to dashboard Cite

Background. Successful renal transplantation (RTx) relies on immunosuppression and an optimal surgical course with few surgical complications. Studies reporting the postoperative complications after RTx are heterogeneous and often lack systematic reporting of complications. This study aims to describe and identify postoperative short-term and long-term complications after RTx in a large institutional cohort and identify risk factors for a complicated surgical course. Methods. The study is a retrospective single-center cohort of 571 recipients who underwent living or deceased donor open RTx between 2014 and 2021. Data were collected on background information and perioperative and postoperative data. Complications were defined as short-term (<30 d) or long-term (>30 d) after transplantation and graded according to the Clavien-Dindo classification. Multivariable logistic regression was performed to evaluate risk factors for serious short-term complications and multivariable time-dependent Cox regression to evaluate risk factors for long-term complications. Results. A total of 351 patients received a graft from a deceased donor, and 144 of these grafts were on perfusion machine before transplantation. One or more short-term complications occurred in 345 (60%) patients. Previous RTx was associated with short-term Clavien-Dindo >2 complications in recipients (odds ratio = 2.08; 95% confidence interval [CI], 1.18-3.69; P = 0.01). Being underweight (body mass index <18.5) in combination with increasing age increased the odds of short-term Clavien-Dindo >2 and vascular complications. Increasing blood loss per 100 mL was associated with increased odds of short-term Clavien-Dindo >2 (odds ratio = 1.11; 95% CI, 1.01-1.21; P = 0.032). No associations were found for long-term complications after RTx. The 5-y cumulative incidence of graft loss was 12.6% (95% CI, 8.9-16.3). Conclusions. Short-term complications are common after RTx, and risk factors for severe short-term complications include previous RTx, increasing age, and low body mass index. No risk factors were identified for severe long-term complications. Further studies should explore whether new surgical techniques can reduce surgical complications in RTx.

show abstract

Section: Discussionmentioning

confidence: 98%

“…5,12-15 Underweight (BMI <18.5) has been shown to affect long-term graft survival but has not conclusively shown to affect postoperative complications in kidney transplantation. 16…”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Surgical Complications Following Renal Transplantation in a Large Institutional Cohort

Dagnæs-Hansen,

Kristensen,

Stroomberg

et al. 2024

Transplantation Direct

View full text Add to dashboard Cite

show abstract

“…Interestingly, one study exploring the effect of BMI <18.5 kg/m 2 on kidney transplantation found no impact on the rate of surgical complications or early postoperative kidney function but did find lower long-term graft survival in those with BMI <17 kg/ m 2 . 24 Frailty and Delirium. A meta-analysis of 6279 patients from 13 cohort studies exploring kidney transplantation recipients with or without the diagnosis of frailty identified a 22.9% frailty rate in this population.…”

Section: Kidney Transplantationmentioning

confidence: 99%

Section: Kidney Transplantationmentioning

confidence: 99%

Abdominal Organ Transplantation: Noteworthy Literature in 2023

Katayama,

Maffucci,

Domanski

et al. 2024

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

This review highlights noteworthy literature published in 2023 and pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We feature 9 studies from 593 peer-reviewed papers on pancreatic transplantation, 3 from 194 on intestinal transplantation, and 28 from over 4513 on kidney transplantation. The liver transplantation section includes a special focus on 20 studies from 5666 clinical trial publications. We explore a broad range of topics, including donor management, perioperative recipient management, and innovative pharmacologic and mechanical interventions tested for the improvement of patient and graft outcomes and survival.

show abstract

Effect of Pre-Transplant Recipient Underweight on the Postoperative Outcome and Graft Survival in Primary Kidney Transplantation

Cited by 2 publications

References 36 publications

Surgical Complications Following Renal Transplantation in a Large Institutional Cohort

Surgical Complications Following Renal Transplantation in a Large Institutional Cohort

Abdominal Organ Transplantation: Noteworthy Literature in 2023

Contact Info

Product

Resources

About