Death risk higher in obese kidney transplant cases

Obese individuals who undergo kidney transplantation are more likely to die and have a poor outcome than their nonobese counterparts, Dutch researchers report.

“Past studies looking at the effect of obesity on transplantation outcomes have yielded conflicting results,” senior author Dr. Andries Hoitsma, from the University Medical Center St. Radboud in Nijmegen, told Reuters Health. “The strength of our study is the large sample size.”

The study, reported in the November issue of Transplant International, included 196 obese patients with a body mass index (BMI) of at least 30 and 1871 nonobese patients. Obese patients were more likely to be female and were typically older than nonobese patients.

Patient survival and graft survival were significantly lower in the obese group, both at 1 and 5 years, the report indicates. At 5 years, the survival rate of obese patients was 81 percent, versus 89 percent for nonobese patients. The graft survival rate was 71 percent in obese patients versus 80 percent in nonobese patients. These differences are significant.

Hoitsma said that surgeons in The Netherlands will usually not perform kidney transplantation on patients with a BMI of 30 or higher, unless certain conditions are met and then the limit is 35.

“Obese patients seeking transplantation are typically instructed to lose weight first,” Hoitsma said.

Research has shown that obese patients who undergo transplantation are better off than if they had remained on dialysis, he noted. However, “with limited grafts available, it is more efficient if the transplants go to patients who are likely to derive the most benefit from them,” namely the nonobese.

SOURCE: Transplant International, November 2006.

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