Background: We evaluate outcomes of super obese patients (BMI>50) undergoing kidney transplantation in the US. Method: We performed a review of 190 super obese patients undergoing kidney transplantation from 1988 through 2013 using the UNOS dataset. Results: Super obese patients had a mean age of 45.7 years (21-75 years) and 111 (58.4%) were female. The mean BMI of the super obese group was 56 (range 50.0-74.2). The 30-day perioperative mortality and length of stay was 3.7% and 10.09 days compared to 0.8% and 7.34 days in non-super obese group.

On multivariable analysis, BMI>50 was an independent predictor of 30-day mortality, with a 5.1 fold increased risk of perioperative death. BMI>50 increased the risk of delayed graft function and length of stay by two fold. The multivariable analysis of survival showed an 82% increased risk of death in this group. Overall patient survival for super obese transplant recipients at 1, 3 and 5 years was 88%, 82% and 76%, compared to 96%, 91%, 86% on patients transplanted with BMI <50. A propensity score analysis further demonstrates significant worse survival rates in super obese patients undergoing kidney transplantation.

Conclusion: Super obese patients had prolonged LOS and worse DGF rates. Perioperative mortality was increased 5 fold compared to patients with BMI<50. Super obesity was an independent predictor of long term overall graft and patient survival.

CITATION INFORMATION: Gedaly R, Kanthawar P, Mei X, Daily M, Shah M, Berger J, Castellanos A, Marti F. Outcomes of Super Obese Patients Undergoing Kidney Transplantation: A Propensity Match Analysis from the UNOS Dataset. Am J Transplant. 2016;16 (suppl 3).

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