ATC Abstracts

American Transplant Congress abstracts

Does the NSQIP-Transplant Experience Demonstrate That Obese Kidney Transplant Recipients are Still at Increased Risk for Surgical Site Infections?

1Surgery, Montefiore-Einstein Center for Transplantation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 2Surgery, University of California San Diego, San Diego, CA, 3Surgery, Division of Abdominal Transplant Surgery, Duke University Medical Center, Durham, NC, 4Surgery, Transplant Surgery Division, Massachusetts General Hospital, Boston, MA, 5Surgery, Division of Transplant Surgery, University of Colorado Hospital, Aurora, CO, 6Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, 7Surgery, University of California San Francisco, San Francisco, CA

Meeting: 2021 American Transplant Congress

Abstract number: 380

Keywords: , , ,

Topic: Clinical Science » Organ Inclusive » Surgical Issues (Open, Minimally Invasive):All Organs

Session Information

Session Name: Surgical Issues and Deceased Donor Management

Session Type: Rapid Fire Oral Abstract

Date: Tuesday, June 8, 2021

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:30pm-6:35pm

Location: Virtual

*Purpose: The National Surgical Quality Improvement Program for Transplant (NSQIP-T) was designed to track surgical outcomes in adult liver and kidney transplants (KTX). The Pilot Beta Phase has captured data between March 1, 2017 and March 31, 2019, at 30 US centers. It is important to investigate how the pilot data informs us on recent outcomes. Increased BMI has historically been identified as a risk factor for SSI following KTX. We examined whether it is a risk factor for SSI in this cohort’s KTX recipients.

*Methods: Of the 3771 KTX recipients captured in NSQIP-T, 116 experienced at least 1 SSI. We divided the cohort into those who experienced an SSI (N=116) and those who did not (N=3655). We conducted univariate and multivariate log regression analyses to identify risk factors for SSI.

*Results: Significant cohort demographic characteristics are listed in Table 1. On multivariate regression, BMI was found to confer increased risk of SSI. Table 2 lists the significant variables on multivariate analysis. The influence of BMI on SSI incidence was investigated by a ROC curve: AUC=0.66 (95%CI=0.61-0.71). The cutoff value was selected from the coordinates of the curve at BMI=27.5 kg/m2.

Table 1. Significant cohort demographics

Parameter SSI present (N=116) SSI absent (N=3655) P-value
African-American ethnicity 29.2% 21.7% 0.02
Employed 24.1% 36.6% 0.007
Non-private health insurance 69% 60% 0.008
Prior transplant 23.3% 13.9% 0.005
Diabetes mellitus 43% 30% 0.005
BMI 31+5.81 kg/m2 27+36.7 kg/m2 <0.001
Albumin 3.7+5.14 g/dL 3.8+5.07 g/dL 0.01
Operative time 200+76.0 min 186+80.8 min 0.02
Length of stay 5+8.11days 4+3.80 days <0.001

Table 2. Significant risk factors for SSI on multivariate log regression

Parameter OR 95%CI
African-American ethnicity 0.33 0.15-0.75
Employment 0.55 0.32-0.94
Prior Transplant 1.07 1.04-1.11
BMI 1.11 1.07-1.16
Length of stay 1.07 1.04-1.11

*Conclusions: Increasing BMI persists as a risk factor for SSI in this cohort, but most accurately predicts an SSI at a non-obese BMI=27.5 kg/m2. Therefore, obese and morbidly obese BMI cannot reliably be used in isolation as predictors of SSI in KTX recipients.

To cite this abstract in AMA style:

Yaffe HC, Belli AK, Parekh JR, Sudan DL, Elias N, Conzen KD, Foley DP, Hirose R, Greenstein SM. Does the NSQIP-Transplant Experience Demonstrate That Obese Kidney Transplant Recipients are Still at Increased Risk for Surgical Site Infections? [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/does-the-nsqip-transplant-experience-demonstrate-that-obese-kidney-transplant-recipients-are-still-at-increased-risk-for-surgical-site-infections/. Accessed May 17, 2025.

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