Kidney Transplantation in the Obese Transplant Candidates: To Transplant or Not To Transplant?
Article first published online: 9 JUL 2013
© 2013 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 26, Issue 5, pages 568–577, September–October 2013
How to Cite
Pham, P.-T. T., Danovitch, G. M. and Pham, P.-C. T. (2013), Kidney Transplantation in the Obese Transplant Candidates: To Transplant or Not To Transplant?. Seminars in Dialysis, 26: 568–577. doi: 10.1111/sdi.12109
- Issue published online: 16 SEP 2013
- Article first published online: 9 JUL 2013
The prevalence of obesity (body mass index ≥30 kg/m2) at the time of transplantation among kidney transplant recipients in the United States has doubled between 1987 and 2001 and continues to increase inexorably. Single-center and large registry studies in kidney transplant recipients demonstrated that high body mass index (BMI) at transplant is associated with increased risk of wound and surgical site infections, delayed graft function (DGF), acute rejection episodes, and graft loss, among others. Hence, in many centers, obese transplant candidates are denied a transplant based on their body mass index (BMI) alone. The impact of obesity on short- and long-term graft and patient outcomes after kidney transplantation are herein revisited, followed by the authors' proposed approach to evaluate and select obese transplant candidates for a kidney transplant. Suggested interventions to optimize the health of such candidates are also discussed.