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Can We Successfully Overcome Obesity as a Barrier for Kidney Transplantation?

K. Zorbas,1 S. Karhadkar,1 S. Rao,2 K. Lau,1 I. Lee,2 A. Gillespie,2 S. Constantinescu,2 A. Karachristos,1 A. Di Carlo.1

1Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
2Nephrology, Temple University, Philadelphia, PA

Meeting: 2017 American Transplant Congress

Abstract number: C84

Keywords: Allocation, Kidney transplantation, Morbidity, Obesity

Session Information

Session Name: Poster Session C: Donor Management: All Organs

Session Type: Poster Session

Date: Monday, May 1, 2017

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

 Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Obesity is a significant barrier for kidney transplantation (KT) with higher rates of denial for listing and longer listing to transplantation interval. We examined the association between candidates BMI and demographic characteristics, evaluation time, listing rates and KT outcomes. Methods: 323 consecutive patients evaluated for KT at a single transplant center from 1/2014 to 12/31/2015 were separated in 5 groups based on BMI. Results: Overall, the mean age was 57±13yrs, with 65% males, 49% African Americans; ESRD cause was diabetes in 41% and hypertension in 15%; 79% of the patients were on dialysis: mean duration 1563±1271 days. There were no significant differences in gender, race, primary diagnosis, and type and vintage of dialysis among the five BMI groups of patients. The overweight patients were older, while class II and III obesity patients were younger. The interval between evaluation and listing decision was between 4.6 to 5.3 months, and 45% to 59% of patients were listed, without significant differences amongst the 5 BMI groups.

Table 1- Patients Characteristics and outcomes (n=323)
BMI <25

Normal/ Underweight

(n=86)

BMI 25-29.9

Overweight

(n=109)

BMI 30-34.9

Class I Obesity

(n=71)

BMI 35-39.9

Classs II Obesity

(n=37)

BMI ≥40

Class III Obesity

(n=20)

p-value
Age (years) 56(±13) 60(±13) 58(±10) 54(±11) 54(±14) 0.01
Males 58% 71% 65% 62% 60% NS
African American 48% 51% 49% 54% 50%
Preemptive 16% 22% 21% 17% 5%
Evaluation Period (days) 159(±132) 141(±117) 161(±132) 152(±116) 139(±31)
Listed (%) 54% 49% 59% 62% 45%
Transplanted from listed 26% (n=12) 46%(n=25) 33%(n=14) 26%(n=6) 22%(n=2)
1 Yr Patient Survival 100% 92% 93% 100% 100%
1 Yr Graft Survival 100% 80% 86% 83% 100%

Conclusions: Broader eligibility criteria allow access to KT for ESRD patients with high BMI. Our results showed similar rates of listing and transplantation among a broad BMI range. Long-term graft and patient outcomes warrant further study.

CITATION INFORMATION: Zorbas K, Karhadkar S, Rao S, Lau K, Lee I, Gillespie A, Constantinescu S, Karachristos A, Di Carlo A. Can We Successfully Overcome Obesity as a Barrier for Kidney Transplantation? Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Zorbas K, Karhadkar S, Rao S, Lau K, Lee I, Gillespie A, Constantinescu S, Karachristos A, Carlo ADi. Can We Successfully Overcome Obesity as a Barrier for Kidney Transplantation? [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/can-we-successfully-overcome-obesity-as-a-barrier-for-kidney-transplantation/. Accessed May 13, 2025.

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