Cumulative Incidence and Factors Associated with Return to Active Status among Temporarily Inactive Obese Renal Transplant Candidates
Division of Nephrology, Department of Internal Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
Meeting: 2013 American Transplant Congress
Abstract number: 533
Background: We studied the cumulative incidence and predictors of return to active status and transplant of obese kidney candidates designated temporarily inactive (status 7) due to a "weight inappropriate for transplant (reason 9) on the United Network for Organ Sharing (UNOS) waiting list.
Methods: All adult kidney candidates in the OPTN/UNOS database with an initial registration between 2006-2010, body mass index (BMI)≥30 kg/m2, and designation of status 7 due to reason 9 within 90 days of registration were included. The cumulative incidence of return to active status, transplant, death, and delisting was described using Fine and Gray competing risks regression. Cause-specific hazards of return to active status and transplant were calculated using Cox proportional hazards models.
Results: Among 1557 waitlisted candidates, the cumulative incidence of return to active status at 6 years was 48%, for transplant was 23%, for death was 16%, and for delisting was 21%. Only 15% remained inactive at 6 years (fig. 1). The strongest predictor of failure to return to active status was BMI at registration. Each BMI category increase was associated with a lower hazard of return to active status (P for trend<0.001). Female gender, race, diabetes, and dialysis at registration were also associated with a failure to return to active status (table 1).
Conclusion: Only 48% of reason 9 obese kidney candidates achieved active status within 6 years of registration, with the majority activated within 3 years. Of those not activated, most died or delisted, suggesting that more precise prediction tools should be developed to identify obese candidates who will realistically attain a weight appropriate for transplant.
To cite this abstract in AMA style:
Shye M, Kamgar M, Mehrnia A, Bunnapradist S, Huang E. Cumulative Incidence and Factors Associated with Return to Active Status among Temporarily Inactive Obese Renal Transplant Candidates [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/cumulative-incidence-and-factors-associated-with-return-to-active-status-among-temporarily-inactive-obese-renal-transplant-candidates/. Accessed October 9, 2024.« Back to 2013 American Transplant Congress