Kidney Transplantation and Obesity: Are There Any Differences in Outcomes?

Abstract

Introduction Kidney transplantation (KT) is the gold standard treatment for end‐stage renal disease (ESRD) patients. Obesity is a strong risk factor for developing cardiovascular disease, chronic kidney disease, and ESRD. This study aimed to investigate the outcomes of kidney transplantation in obese recipients. Material and methods We retrospectively reviewed the medical records of recipients from January 2016 to December 2021 in a single center. Outcomes in recipients of a kidney allograft with BMI ≥ 30 were compared with the outcomes in recipients with 30 < BMI. Results A total of 467 consecutive kidney transplantation recipients’ files were studied. 213 (45.6%) allograft recipients had a BMI ≥ 30, and 254 (54.4%) allograft recipients had a BMI < 30. DGF rate was 29.1% in the BMI ≥ 30 and 30.7% in the BMI < 30 group (P = 0.41). On the other hand, 30 days readmission rate also did not show a significant difference between the BMI ≥ 30 and BMI < 30 allograft recipients (37 vs. 33.8%, P = 0.46). The mean overall costs of transplantation in the BMI ≥ 30 group was $254,395, and it was $256,029 in the BMI < 30 group (P = 0.84). Conclusion Our study shows that the outcomes of renal allograft transplant were comparable between recipients with BMI ≥ 30 and BMI < 30 in terms of DGF, LOS, 30 days readmission, acute rejection rate, and survival rates, and BMI should not be a single independent criterion for decision making to select an optimal recipient.

Abdominal Organ Transplantation: Noteworthy Literature in 2023

“…22 The authors observed higher rates of new onset diabetes and cardiovascular disease in the post-transplant BMI ≥25 kg/m 2 group and suggested that strategies to maintain a lower BMI in kidney transplant recipients may help prevent the associated impact of diabetes mellitus on graft and patient survival. However, another retrospective study of 467 kidney transplant recipients found no differences in the rate of acute rejection, delayed graft function, and survival rate between patients with BMI <30 kg/m 2 and those ≥30 kg/m 2 , 23 although this study did not distinguish between pre- and post-transplant BMI. 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 .…”

Letter to the Editor: Kidney Transplantation and Obesity are There Any Differences in Outcomes?

“…We read with interest the article by Mahmoudreza Moein et al recently published in WJS [1], in which the authors retrospectively analyzed a single‐center case series of 467 adult patients undergoing kidney transplantation (KT). The aim of this study was to demonstrate that BMI ≥ 30 is not an independent risk factor (RF) for KT outcome in terms of costs, 30‐day readmission, acute rejection (AR), delayed graft function (DGF), length of hospital stay, patient and graft survival.…”

Invited Commentary: Kidney Transplantation and Obesity: Are There Any Differences in Outcomes?

“…Based on this contemporary, single-center report, the answer to the question posed in the title is ''No'' [1].…”