Obesity as a Risk Factor Following Renal Transplantation1

Pirsch, John D.; Armbrust, Michael; Knechtle, Stuart J.; D’Alessandro, Anthony M.; Sollinger, Hans W.; Heisey, Dennis M.; Belzer, Folkert O.

doi:10.1097/00007890-199559040-00033

Cited by 82 publications

(83 citation statements)

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“…Similar findings were also observed by Drafts et al [16]. On the other hand some have revealed association between obesity and posttransplant complications containing, graft survival [19], urological complication and DGF [26]. This disparity might be caused by improvement in patient management and transplant outcomes over the time.…”

Section: Discussionsupporting

confidence: 85%

Impact of obesity on urologic complications among unrelated living donor kidney transplants

Kamali¹,

Abbasi²,

Abbasi

et al. 2010

Indian J Surg

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Purpose Although obesity has been associated with improved survival on dialysis, its effects on renal transplantation outcomes remain unclear. Herein we aimed to evaluate the effect of obesity on posttransplantation complications. Results We included 180 patients, 34 (18%) were obese (body mass index >30 kg/m 2 ) and 146 were lean.Obese patients were more likely to develope renal artery stenosis (17.6% vs 2.8%, p < 0.001), hematoma (47.9% vs 17.6, p = 0.009), wound complications (64.7% vs 9.6%, P < 0.001) and renal vein thrombosis(2% vs 0%, p < 0.001). Urologic complications consisting ureteral, ureteropelvic and ureterovesicular junction stenosis, wound bleeding, urinary leakage and renal artery thrombosis and also hospitalization time were found similar between the two groups. 2 year patiets and graft survival were not statististically different. Patients and methodsConclusions Renal transplantation could be performed with reasonable urologic complications in obese patients

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Section: Discussionsupporting

confidence: 85%

Impact of obesity on urologic complications among unrelated living donor kidney transplants

Kamali¹,

Abbasi²,

Abbasi

et al. 2010

Indian J Surg

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“…The available paediatric evidence appears to suggest a similar experience, with little difference in the rate of acute rejection between obese and non-obese patients. In keeping with observations from an earlier work [29], Mitsnefes et al reported that obese children had an equivalent risk of developing acute rejection as normal weight children in the first year post-transplant [7]. Indeed, similar findings were also reported in a large study of over 6500 children using the North American Paediatric Renal Transplant Cooperative Study (NAPRTCS) registry [23].…”

Section: Graft Functionsupporting

confidence: 78%

Paediatric obesity and renal transplantation: current challenges and solutions

Terrace

Oniscu

2015

Pediatr Nephrol

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The increased incidence of obesity in the paediatric population poses significant challenges to renal transplantation. Whilst the body mass index appears to be widely used as a measure of obesity in adults, there are no standardised definitions in the paediatric population, making comparative analyses difficult. In the paediatric transplant population, obesity is associated with an increased incidence of surgical complications, diabetes, hyperlipidaemia and cardiovascular morbidity, leading to diminished graft function and impacting patient and graft survival. Management of obesity in renal transplantation requires multiple interventions starting with lifestyle and behavioural modification combined with medical and possibly surgical therapies, representing a unique challenge in the childhood setting. In this review we discuss the current challenges of obesity and potential solutions in the setting of paediatric transplantation.

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“…In contrast, obesity is an important risk factor for renal transplant recipients and is considered by many transplant centers one of the exclusion criteria for renal transplantation for at least some individuals (907)(908)(909). Approximately 10-18% of transplant recipients have a pretransplant BMI Ø30 kg/m 2 (910,911). Obese renal transplant recipients (BMI Ø30 kg/m 2 ) have higher rates of delayed graft function and suffer from more surgical complications, including wound infections, than non-obese renal transplant recipients (910)(911)(912)(913)(914).…”

Section: Endocrinementioning

confidence: 99%

“…Approximately 10-18% of transplant recipients have a pretransplant BMI Ø30 kg/m 2 (910,911). Obese renal transplant recipients (BMI Ø30 kg/m 2 ) have higher rates of delayed graft function and suffer from more surgical complications, including wound infections, than non-obese renal transplant recipients (910)(911)(912)(913)(914). Obesity is also associated with a prolonged posttransplant hospital length of stay and increased cost of transplantation (615).…”

Section: Endocrinementioning

confidence: 99%

“…The incidence of posttransplant diabetes mellitus is also higher in obese renal transplant recipients (909,911). Several transplant centers have reported increased immunological graft losses and decreased graft survival associated with higher mortality rates in obese renal transplant recipients (908)(909)(910)915). Other transplant centers, however, have not observed significant correlations between obesity and graft survival rates (911).…”

Section: Endocrinementioning

confidence: 99%

See 1 more Smart Citation

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

2001

American Journal of Transplantation

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Obesity as a Risk Factor Following Renal Transplantation1

Cited by 82 publications

References 0 publications

Impact of obesity on urologic complications among unrelated living donor kidney transplants

Impact of obesity on urologic complications among unrelated living donor kidney transplants

Paediatric obesity and renal transplantation: current challenges and solutions

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

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