Lower Survival for Obese Kidney-Transplant Patients

Obese kidney-transplant patients are twice as likely to die or suffer organ failure during the first year following surgery, according to a new study.

Nephrology specialists from seven university hospitals across the Netherlands studied the medical profiles of 4,245 adults who had received kidney transplants, using data from the Netherlands organ transplantation registry. In 2,067 cases, there was sufficient information to calculate the body mass index (BMI)--based on weight and height--at the time of the kidney transplant. Obese patients in the study group tended to be older and were more likely to be female.

The researchers found that 6% of patients with a BMI of more than 30 died in the first year after transplant, compared with 3% of patients with a BMI of less than 30. By year five, the difference was even greater, with an 81 % survival rate for the obese patients and an 89 % survival rate for patients who were not obese. The same pattern emerged when the researchers looked at the success of the transplant itself. A year after the transplant was carried out, 14% of obese patients had experienced a transplant failure, compared with 8% of non-obese patients. After five years, 71% of obese patients still had a successfully transplanted kidney, compared with 80% of the patients with a lower BMI.

Obese patients were more likely to suffer transplant failure through infection or permanent non-functioning, but the numbers for obese and non-obese patients were both fairly low. There were no significant differences between the two groups when it came to why patients died, but there was a trend for obese patients to suffer more infections and fatal heart conditions. The study was published in the November 2006 issue of Transplant International.

"Our conclusion is that it's not fair to deny obese patients the chance of a kidney transplant as they still do better after a transplant than on dialysis,” said lead author Dr. Jeroen Aalten from the department of nephrology at the University Medical Center Nijmegen (The Netherlands). "However we shouldn't disregard the increased risk for obese patients after transplantation and we also need to bear in mind that it is important to give scarce resources to patients with the lowest risk.”



Related Links:
University Medical Center Nijmegen