Should Obese Patients Undergo Renal Transplantation? A Retrospective Analysis to Assess Whether Body Mass Index Can Affect Transplant Outcome.
1St. George's, University of London, London, United Kingdom
2Renal Transplant Unit, St. George's Hospital, London, United Kingdom.
Meeting: 2016 American Transplant Congress
Abstract number: A255
Keywords: Graft survival, Kidney transplantation, Obesity, Post-operative complications
Session Information
Session Name: Poster Session A: Poster Session III: Kidney Complications-Other
Session Type: Poster Session
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
This study aims to analyze our renal transplant recipient population in terms of perioperative complications (90 day) and graft survival (3 years) in relation to their Body Mass Index (BMI).
We performed a retrospective analysis of our renal transplant unit between 2008-2013. We divided patients into three cohorts based on BMI (kg/m2) [Cohort A<25, B 25-29.99, C≥30] and recorded their basic demographics, risk factors, perioperative complications and graft survival. [Chi]-square analysis was used to assess statistical significance between BMI and type of complication. A one-way Analysis of Variance (ANOVA) was applied to assess statistical significance between BMI and number of complications per patient.
Study sample size = 610:[Cohort A=294, B=224, C=92, excluded=24]. The sample included 6 'underweight' patients (BMI<18) and 6 'moderately obese' patients (BMI: 35-39.99). No patients were 'morbidly obese' (BMI>40).
Table: BMI vs. Surgical Complication
| Complication |
Affects Graft? |
A (N=294) |
B (N=224) | C (N=92) | TOTAL (N=610) |
| Rejection | 78 | 58 | 28 | 164 | |
| Delayed Graft Function | Y | 52 | 53 | 21 | 126 |
| Urinary Infection | 52 | 44 | 18 | 114 | |
| Wound Infection | 30 | 30 | 15 | 75 | |
| Lymphocele | 10 | 10 | 11 | 31 | |
| Other Collection | 17 | 18 | 15 | 50 | |
| Primary Graft Failure | Y | 6 | 6 | 1 | 13 |
| Bleeding | 5 | 6 | 1 | 12 | |
| Transplant Renal Artery Stenosis | Y | 6 | 2 | 3 | 11 |
| Ureteric Stenosis | 3 | 5 | 3 | 11 | |
| Renal Vein Thrombosis | Y | 3 | 1 | 1 | 5 |
| TOTAL |
262 | 233 | 117 | 612 | |
| AVERAGE |
0.9 | 1.0 | 1.3 | 1.0 |
– Significant [Chi]-square: Lymphocele (p = 0.004), Other Collection (p = 0.015)
– Significant ANOVA for BMI vs. Number of Complications per patient: [F = 3.89; F Critical = 3.01; p = 0.021]. Two-tail t-tests assuming unequal variances verified the multiple comparisons and proved significant (p = 0.039 – Bonferroni corrected) for Cohort A vs. C.
– Three years graft survival (censored data): [Cohort A 92%, B 91%, C 94%]
Our results show that obesity is associated with increased risk of perioperative complication- in particular with lymphocele and post-operative collection. Fortunately, neither had any impact on graft survival (i.e. long-term outcome). Therefore, we suggest that with careful perioperative planning and informed consent, renal transplant should still be considered as a gold standard treatment in obese patients.
CITATION INFORMATION: Mehta A, Marriott A, Ghazanfar A. Should Obese Patients Undergo Renal Transplantation? A Retrospective Analysis to Assess Whether Body Mass Index Can Affect Transplant Outcome. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mehta A, Marriott A, Ghazanfar A. Should Obese Patients Undergo Renal Transplantation? A Retrospective Analysis to Assess Whether Body Mass Index Can Affect Transplant Outcome. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/should-obese-patients-undergo-renal-transplantation-a-retrospective-analysis-to-assess-whether-body-mass-index-can-affect-transplant-outcome/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress