S. Kaur1, L. Greco1, K. Lau1, A. Di Carlo1, S. Karhadkar1 1Temple University,Surgery / Division Of Abdominal Organ Transplantation,Philadelpha, PA, USA
Introduction:
Candidacy for renal transplantation is multifactorial and one of the variables factored in this decision is recipient obesity. Obesity has been shown to be associated with an increased risk of allograft dysfunction, however the association between obesity and short-term complications remains unclear. There is an increasing trend to subject obese patients to bariatric surgery before transplantation. The purpose of this study is to evaluate the association between obesity and the risk of short and long-term complications after renal transplantation.
Methods:
We identified consecutive patients who underwent renal transplantation at a single center between the years 2013 and 2018. The body mass index (BMI) was calculated for all patients and patients were stratified by BMI: Obese (BMI greater than 30) and non-obese (BMI less than 30). Patient charts were reviewed for infectious complications, rejection of allograft, new onset diabetes, return to dialysis after transplant, and proteinuria. Student’s paired T-test and odds ratios were calculated to assess the relationship between obesity and the aforementioned complications.
Results:
A total of 246 patients underwent renal transplant between 2013 and 2018, 63.3% (n=155) were male, 91.1% (n=224) underwent deceased donor transplant, 85.0% (n=209) were on dialysis prior to transplant. In these patients, 2% (n=5) were underweight (BMI<18.5), 28% (n=69) were normal BMI (18.5-24.9), 35% (n=86) were overweight (BMI 25-29.9), and 34.6% (n=85) were overweight (BMI >30). There was no difference between the obese and non-obese kidney transplant recipients with regards to incidence of return to dialysis after transplant (p<0.458, OR 0.606), new onset of diabetes after transplant (p<0.874, OR 0.915), or proteinuria (p<0.188, OR 1.424). Additionally, in patients who had complications following transplant, there was no significant difference in the obese and non-obese transplant recipients and incidence of organ rejection (p<0.340, OR 0.703) or complications that were classified as not secondary to infection or rejection (p<0.965, OR 1.017). There was a weak association of obesity with increased risk of infectious complication (p<0.051, OR 2.199).
Conclusion:
In patients undergoing kidney transplantation, there is no significant difference in incidence of complications in obese patients compared to non-obese patients. There is a weak association of obesity with increased risk of infectious complication that is not significant. High BMI is not associated with proteinuria, graft loss or rejection. Obesity should not be a contra-indication for Renal Transplantation.
