Comparable kidney transplant outcomes in selected patients with a body mass index ≥ 40: A personalized medicine approach to recipient selection

被引：0

作者：

Jacobs, Marie L. L. ^{[1
]}

Dhaliwal, Karanpreet ^{[2
]}

Harriman, David I. I. ^{[3
]}

Rogers, Jeffrey ^{[4
]}

Stratta, Robert J. J. ^{[4
]}

Farney, Alan C. C. ^{[4
]}

Orlando, Giuseppe ^{[4
]}

Reeves-Daniel, Amber ^{[5
]}

Jay, Colleen ^{[4
]}

机构：

[1] Univ Rochester, Sch Med, Rochester, NY USA

[2] Univ Washington, Med Ctr, Seattle, WA USA

[3] Univ British Columbia, Dept Urol Sci, Vancouver, BC, Canada

[4] Atrium Hlth Wake Forest Baptist, Dept Surg, Sect Transplantat, One Med Ctr Blvd, Winston Salem, NC 27157 USA

[5] Atrium Hlth Wake Forest Baptist, Dept Internal Med, Sect Nephrol, Winston Salem, NC USA

来源：

CLINICAL TRANSPLANTATION | 2023年 / 37卷 / 08期

关键词：

body mass index; computed tomography; kidney transplantation; obesity; MORBID-OBESITY; RISK FACTOR; CANDIDATES; DIALYSIS; ACCESS; IMPACT; BMI;

D O I：

10.1111/ctr.14903

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

IntroductionMany kidney transplant (KT) centers decline patients with a body mass index (BMI) >= 40 kg/m(2). This study's aim was to evaluate KT outcomes according to recipient BMI. MethodsWe performed a single-center, retrospective review of adult KTs comparing BMI >= 40 patients (n = 84, BMI = 42 +/- 2 kg/m(2)) to a matched BMI < 40 cohort (n = 84, BMI = 28 +/- 5 kg/m(2)). Patients were matched for age, gender, race, diabetes, and donor type. ResultsBMI >= 40 patients were on dialysis longer (5.2 +/- 3.2 years vs. 4.1 +/- 3.5 years, p = .03) and received lower kidney donor profile index (KDPI) kidneys (40 +/- 25% vs. 53 +/- 26%, p = .003). There were no significant differences in prevalence of delayed graft function, reoperations, readmissions, wound complications, patient survival, or renal function at 1 year. Long-term graft survival was higher for BMI >= 40 patients, including after adjusting for KDPI (BMI >= 40: aHR = 1.79, 95% CI = 1.09-2.9). BMI >= 40 patients had similar BMI change in the first year post-transplant (delta BMI: BMI >= 40 +.9 +/- 3.3 vs. BMI < 40 +1.1 +/- 3.2, p = .59). ConclusionsOverall outcomes after KT were comparable in BMI >= 40 patients compared to a matched cohort with lower BMI with improved long-term graft survival in obese patients. BMI-based exclusion criteria for KT should be reexamined in favor of a more individualized approach.

引用

页数：11