Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Johnson DW, Isbel NM, Brown AM, Kay TD, Franzen K, Hawley CM, Campbell SB, Wall D, Griffin A, Nicol DL. The effect of obesity on renal transplant outcomes. Transplantation 2002;74:675-81. [PMID: 12352885 DOI: 10.1097/00007890-200209150-00015] [Citation(s) in RCA: 184] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]

For:	Johnson DW, Isbel NM, Brown AM, Kay TD, Franzen K, Hawley CM, Campbell SB, Wall D, Griffin A, Nicol DL. The effect of obesity on renal transplant outcomes. Transplantation 2002;74:675-81. [PMID: 12352885 DOI: 10.1097/00007890-200209150-00015] [Citation(s) in RCA: 184] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]

Number

Cited by Other Article(s)

Attia A, Toraih EA, Ardis C, Omar M, Abdelmaksoud A, Tatum D, Killackey M, Levy S, Paramesh A. Metabolic and Bariatric Operation and the Path to Kidney Transplantation. J Am Coll Surg 2025;240:564-575. [PMID: 39868699 DOI: 10.1097/xcs.0000000000001301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2025]

Abstract

BACKGROUND

Obesity is a significant barrier to kidney transplantation for patients with end-stage renal disease (ESRD). We aimed to evaluate the long-term impact of metabolic and bariatric surgery (MBS) on kidney transplantation access and outcomes in individuals with obesity and patients with ESRD.

STUDY DESIGN

A retrospective cohort study using data from 64 US healthcare organizations included 132,989 individuals with obesity (BMI ≥ 30 kg/m²) and ESRD requiring dialysis, of whom 6,263 (4.6%) underwent MBS. Propensity score matching produced 1:1 matched groups of 6,238 patients each, analyzed for 10 years. Primary outcomes included rates of kidney transplant waitlist placement, transplantation, and overall mortality. Secondary outcomes focused on 22,979 transplant recipients, including 1,701 (7.4%) patients who underwent MBS, to evaluate posttransplant adverse events.

RESULTS

During a median follow-up of 33.3 months (MBS) and 28.5 months (controls), patients who underwent MBS demonstrated higher rates of waitlist placement (19.12% vs 10.53%, hazard ratio [HR] 1.800, 95% CI 1.636 to 1.980, p < 0.001) and transplantation (27.06% vs 16.09%, HR 1.712, 95% CI 1.584 to 1.852, p < 0.001) at 10 years, with benefits evident within 1-month postoperation. Mortality was lower in the MBS group (30.55% vs 36.44%, HR 0.768, 95% CI 0.723 to 0.817, p < 0.001). In transplant recipients, patients who underwent MBS had lower cardiovascular complications (37.3% vs 40.6%, risk ratio 0.92, p = 0.007) and all-cause mortality (16.70% vs 20.88%, HR 0.82, p < 0.001), with no significant differences in graft rejection or failure.

CONCLUSIONS

MBS significantly improves access to kidney transplantation and long-term survival for obese patients with ESRD. Patients who underwent MBS demonstrated notable improvements in cardiovascular health, potentially leading to a better quality of life and survival. These findings suggest that MBS should be considered as part of the comprehensive care for this high-risk population.

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Higgins MS, Ismail S, Chen M, Agala CB, Detwiler R, Farrell TM, Hodges MM. Evaluating the safety of bariatric surgery as a bridge to kidney transplant: a retrospective cohort study. Surg Endosc 2024;38:5980-5991. [PMID: 39085668 DOI: 10.1007/s00464-024-11087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 07/13/2024] [Indexed: 08/02/2024]

Abstract

BACKGROUND

Bariatric surgery has been proven safe in end-stage kidney disease (ESKD); however, few studies have evaluated whether a history of bariatric surgery impacts transplant-specific outcomes. We hypothesize that a history of bariatric surgery at the time of transplant does not adversely impact transplant-specific outcomes.

METHODS

The IBM MarketScan Commercial Claims and Encounters database was queried for patients with a history of kidney transplant between 2000 and 2021. Patients were stratified into three groups based on bariatric surgery status and body mass index (BMI) at the time of transplant: patients with obesity (O), patients without obesity (NO), and patients with a history of bariatric surgery (BS). Inverse probability of treatment weighting was used to control for confounding. Adjusted hazard ratios (aHRs) describing the risk of transplant-specific and postoperative outcomes were estimated using weighted Kaplan-Meier curves. Primary outcomes included 30-day and 1-year risk of transplant-specific outcomes. Secondary outcomes included 30-day and 1-year postoperative complications and 30-day and 1-year risk of wound-related complications.

RESULTS

We identified 14,806 patients; 128 in the BS group, 1572 in the O group, and 13,106 in the NO group. There was no difference in 30-day or 1-year risk of transplant-specific complications between the BS and NO group or the O and NO group. Patients with obesity (O) were more likely to experience wound infection (aHR 1.49, 95% CI 1.12-1.99), wound dehiscence (aHR 2.2, 95% CI 1.5-3.2), and minor reoperation (aHR 1.52, 95% CI 1.23-1.89) at 1 year. BS patients had increased risk of wound infection at 1 year (aHR 2.79, 95% CI 1.26-6.16), but were without increase in risk of minor or major reoperation.

CONCLUSION

A history of bariatric surgery does not adversely affect transplant-specific outcomes after kidney transplant. Bariatric surgery can be safely utilized to improve the transplant candidacy of patients with obesity with CKD and ESKD.

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Chandler S, Palamuthusingam D, Hawley CM, Pascoe EM, Johnson DW, McDonald S, Boudville N, Jose MD, Cross NB, Fahim M. Bariatric surgery outcomes in patients on chronic kidney replacement therapy in Australia and New Zealand. Br J Surg 2024;111:znae251. [PMID: 39387471 DOI: 10.1093/bjs/znae251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 09/12/2024] [Accepted: 09/13/2024] [Indexed: 10/15/2024]

Affiliation(s)

Shaun Chandler Metro North Kidney Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
Dharmenaan Palamuthusingam Metro North Kidney Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia School of Medicine, Griffith University, Southport, Queensland, Australia
Carmel M Hawley Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia Australasian Kidney Trials Network (AKTN), University of Queensland, Brisbane, Queensland, Australia Translational Research Institute, Brisbane, Queensland, Australia
Elaine M Pascoe Centre for Health Services Research, University of Queensland, St Lucia, Queensland, Australia
David W Johnson Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia Australasian Kidney Trials Network (AKTN), University of Queensland, Brisbane, Queensland, Australia Translational Research Institute, Brisbane, Queensland, Australia
Stephen McDonald Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Neil Boudville Medical School, University of Western Australia, Perth, Western Australia, Australia Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
Matthew D Jose Department of Nephrology, Royal Hobart Hospital, Hobart, Tasmania, Australia School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
Nicholas B Cross Department of Nephrology, Te Whatu Ora Waitaha Canterbury, Christchurch Hospital, Christchurch, New Zealand Christchurch School of Medicine, University of Otago, Christchurch, New Zealand New Zealand Clinical Research, Christchurch, New Zealand
Magid Fahim Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia Metro North Health Service, Herston, Queensland, Australia

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Prudhomme T, Bento L, Frontczak A, Timsit MO, Boissier R. Effect of Recipient Body Mass Index on Kidney Transplantation Outcomes: A Systematic Review and Meta-analysis by the Transplant Committee from the French Association of Urology. Eur Urol Focus 2024;10:551-563. [PMID: 37993345 DOI: 10.1016/j.euf.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/16/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]

Lam S, Huynh A, Ying T, Sandroussi C, Gracey D, Pleass HC, Chadban S, Laurence JM. Prospective evaluation of a closed-incision negative pressure wound therapy system in kidney transplantation and its association with wound complications. FRONTIERS IN NEPHROLOGY 2024;4:1352363. [PMID: 38476464 PMCID: PMC10929013 DOI: 10.3389/fneph.2024.1352363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024]

Abstract

Introduction

Wound complications can cause considerable morbidity in kidney transplantation. Closed-incision negative pressure wound therapy (ciNPWT) systems have been efficacious in reducing wound complications across surgical specialties. The aims of this study were to evaluate the use of ciNPWT, Prevena™, in kidney transplant recipients and to determine any association with wound complications.

Material and methods

A single-center, prospective observational cohort study was performed in 2018. A total of 30 consecutive kidney transplant recipients deemed at high risk for wound complications received ciNPWT, and the results were compared to those of a historical cohort of subjects who received conventional dressings. Analysis for recipients with obesity and propensity score matching were performed.

Results

In total, 127 subjects were included in the analysis. Of these, 30 received a ciNPWT dressing and were compared with 97 subjects from a non-study historical control group who had conventional dressing. The overall wound complication rate was 21.3% (27/127). There was no reduction in the rate of wound complications with ciNPWT when compared with conventional dressing [23.3% (7/30) and 20.6% (20/97), respectively, p = 0.75]. In the obese subset (BMI ≥30 kg/m2), there was no significant reduction in wound complications [31.1% (5/16) and 36.8% (7/19), respectively, p = 0.73]. Propensity score matching yielded 26 matched pairs with equivalent rates of wound complications (23.1%, 6/26).

Conclusion

This is the first reported cohort study evaluating the use of ciNPWT in kidney transplantation. While ciNPWT is safe and well tolerated, it is not associated with a statistically significant reduction in wound complications when compared to conventional dressing. The findings from this study will be used to inform future studies associated with ciNPWT in kidney transplantation.

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Carullo N, Zicarelli M, Michael A, Faga T, Battaglia Y, Pisani A, Perticone M, Costa D, Ielapi N, Coppolino G, Bolignano D, Serra R, Andreucci M. Childhood Obesity: Insight into Kidney Involvement. Int J Mol Sci 2023;24:17400. [PMID: 38139229 PMCID: PMC10743690 DOI: 10.3390/ijms242417400] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open

Abstract

This review examines the impact of childhood obesity on the kidney from an epidemiological, pathogenetic, clinical, and pathological perspective, with the aim of providing pediatricians and nephrologists with the most current data on this topic. The prevalence of childhood obesity and chronic kidney disease (CKD) is steadily increasing worldwide, reaching epidemic proportions. While the impact of obesity in children with CKD is less pronounced than in adults, recent studies suggest a similar trend in the child population. This is likely due to the significant association between obesity and the two leading causes of end-stage renal disease (ESRD): diabetes mellitus (DM) and hypertension. Obesity is a complex, systemic disease that reflects interactions between environmental and genetic factors. A key mechanism of kidney damage is related to metabolic syndrome and insulin resistance. Therefore, we can speculate about an adipose tissue-kidney axis in which neurohormonal and immunological mechanisms exacerbate complications resulting from obesity. Adipose tissue, now recognized as an endocrine organ, secretes cytokines called adipokines that may induce adaptive or maladaptive responses in renal cells, leading to kidney fibrosis. The impact of obesity on kidney transplant-related outcomes for both donors and recipients is also significant, making stringent preventive measures critical in the pre- and post-transplant phases. The challenge lies in identifying renal involvement as early as possible, as it is often completely asymptomatic and not detectable through common markers of kidney function. Ongoing research into innovative technologies, such as proteomics and metabolomics, aims to identify new biomarkers and is constantly evolving. Many aspects of pediatric disease progression in the population of children with obesity still require clarification. However, the latest scientific evidence in the field of nephrology offers glimpses into various new perspectives, such as genetic factors, comorbidities, and novel biomarkers. Investigating these aspects early could potentially improve the prognosis of these young patients through new diagnostic and therapeutic strategies. Hence, the aim of this review is to provide a comprehensive exploration of the pathogenetic mechanisms and prevalent pathological patterns of kidney damage observed in children with obesity.

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Affiliation(s)

Nazareno Carullo Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (N.C.); (M.Z.); (A.M.); (T.F.); (G.C.)
Mariateresa Zicarelli Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (N.C.); (M.Z.); (A.M.); (T.F.); (G.C.)
Ashour Michael Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (N.C.); (M.Z.); (A.M.); (T.F.); (G.C.)
Teresa Faga Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (N.C.); (M.Z.); (A.M.); (T.F.); (G.C.)
Yuri Battaglia Department of Medicine, University of Verona, 37129 Verona, Italy;
Antonio Pisani Department of Public Health, University Federico II of Naples, 80131 Naples, Italy;
Maria Perticone Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.P.); (D.C.); (D.B.)
Davide Costa Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.P.); (D.C.); (D.B.) Interuniversity Center of Phlebolymphology (CIFL), “Magna Graecia” University, 88100 Catanzaro, Italy;
Nicola Ielapi Interuniversity Center of Phlebolymphology (CIFL), “Magna Graecia” University, 88100 Catanzaro, Italy; Department of Public Health and Infectious Disease, “Sapienza” University of Rome, 00185 Rome, Italy
Giuseppe Coppolino Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (N.C.); (M.Z.); (A.M.); (T.F.); (G.C.)
Davide Bolignano Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.P.); (D.C.); (D.B.)
Raffaele Serra Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.P.); (D.C.); (D.B.) Interuniversity Center of Phlebolymphology (CIFL), “Magna Graecia” University, 88100 Catanzaro, Italy;
Michele Andreucci Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (N.C.); (M.Z.); (A.M.); (T.F.); (G.C.)

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Di Cocco P, Bencini G, Spaggiari M, Petrochenkov E, Akshelyan S, Fratti A, Zhang JC, Almario Alvarez J, Tzvetanov I, Benedetti E. Obesity and Kidney Transplantation-How to Evaluate, What to Do, and Outcomes. Transplantation 2023;107:1903-1909. [PMID: 36855222 DOI: 10.1097/tp.0000000000004564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]

Tsapepas D, Sandra V, Dale LA, Drexler Y, King KL, Yu M, Toma K, Van Bever J, Sanichar N, Husain SA, Mohan S. Retrospective analysis of the impact of severe obesity on kidney transplant outcomes. Nephrol Dial Transplant 2023;38:472-480. [PMID: 35524689 DOI: 10.1093/ndt/gfac169] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Indexed: 11/13/2022] Open

Affiliation(s)

Demetra Tsapepas Department of Analytics, Division of Transplantation, NewYork-Presbyterian Hospital, New York, NY, USA.,Department of Surgery, Division of Transplantation, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA
Vanessa Sandra The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.,Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
Leigh Ann Dale Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Yelena Drexler Department of Medicine, Division of Nephrology, University of Miami, Miami, FL, USA
Kristen L King The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.,Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Miko Yu The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.,Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Katherine Toma Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Jennifer Van Bever Department of Analytics, Division of Transplantation, NewYork-Presbyterian Hospital, New York, NY, USA
Navin Sanichar The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.,Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
S Ali Husain The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.,Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Sumit Mohan The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.,Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

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Moein M, Otero MT, Rood GJ, Hanlon M, Saidi R. Kidney Transplantation and Obesity: Are There Any Differences in Outcomes? World J Surg 2023;47:510-518. [PMID: 36264336 DOI: 10.1007/s00268-022-06806-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2022] [Indexed: 01/04/2023]

Ishikawa S, Tasaki M, Ikeda M, Nakagawa Y, Saito K, Tomita Y. Pretransplant BMI Should Be <25 in Japanese Kidney Transplant Recipients: A Single-Center Experience. Transplant Proc 2023;55:72-79. [PMID: 36528408 DOI: 10.1016/j.transproceed.2022.10.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/24/2022] [Accepted: 10/18/2022] [Indexed: 12/23/2022]

Lemke A, Brokmeier HM, Leung SB, Mara KC, Mour GK, Wadei HM, Hill JM, Stegall M, Kudva YC, Shah P, Kukla A. Sodium-glucose cotransporter 2 inhibitors for treatment of diabetes mellitus after kidney transplantation. Clin Transplant 2022;36:e14718. [PMID: 35593882 DOI: 10.1111/ctr.14718] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/25/2022] [Accepted: 05/12/2022] [Indexed: 01/10/2023]

Body Mass Index Thresholds and the Use of Bariatric Surgery in the Field of Kidney Transplantation in Germany. Obes Surg 2022;32:1641-1648. [PMID: 35305229 PMCID: PMC8986752 DOI: 10.1007/s11695-022-06000-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023]

Abstract

Background

Obesity in the recipient is linked to inferior transplant outcome. Consequently, access to kidney transplantation (KT) is often restricted by body mass index (BMI) thresholds. Bariatric surgery (BS) has been established as a superior treatment for obesity compared to conservative measures, but it is unclear whether it is beneficial for patients on the waiting list.

Methods

A national survey consisting of 16 questions was sent to all heads of German KT centers. Current situation of KT candidates with obesity and the status of BS were queried.

Results

Center response rate was 100%. Obesity in KT candidates was considered an important issue (96.1%; n = 49/51) and 68.6% (n = 35/51) of departments responded to use absolute BMI thresholds for KT waiting list access with ≥ 35 kg/m² (45.1%; n = 23/51) as the most common threshold. BS was considered an appropriate weight loss therapy (92.2%; n = 47/51), in particular before KT (88.2%; n = 45/51). Sleeve gastrectomy was the most favored procedure (77.1%; n = 37/51). Twenty-one (41.2%) departments responded to evaluate KT candidates with obesity by default but only 11 (21.6%) had experience with ≥ n = 5 transplants after BS. Concerns against BS were malabsorption of immunosuppressive therapy (39.2%; n = 20/51), perioperative morbidity (17.6%; n = 9/51), and malnutrition (13.7%; n = 7/51).

Conclusions

Obesity is potentially limiting access for KT. Despite commonly used BMI limits, only few German centers consider BS for obesity treatment in KT candidates by default. A national multicenter study is desired by nearly all heads of German transplant centers to prospectively assess the potentials, risks, and safety of BS in KT waitlisted patients.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s11695-022-06000-4.

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Yin S, Wu L, Huang Z, Fan Y, Lin T, Song T. Nonlinear relationship between body mass index and clinical outcomes after kidney transplantation: A dose-response meta-analysis of 50 observational studies. Surgery 2021;171:1396-1405. [PMID: 34838329 DOI: 10.1016/j.surg.2021.10.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 02/08/2023]

Abstract

BACKGROUND

Exact dose-response relationship between body mass index at transplantation and clinical outcomes after kidney transplantation remained unclear, and no specific body mass index threshold and pretransplant weight loss aim were recommended for kidney transplantation candidates among transplant centers.

METHODS

PubMed, Embase, Web of Science, and Cochrane Library were searched for literature published up to December 31, 2019. The two-stage, random effect meta-analysis was performed to estimate the dose-response relationship between body mass index and clinical outcomes after kidney transplantation.

RESULTS

Ninety-four studies were included for qualitative assessment and 50 for dose-response meta-analyses. There was a U-shaped relationship between graft loss, patient death, and body mass index. Body mass index with the lowest risk of graft loss was 25.2 kg/m², and preferred body mass index range was 22-28 kg/m². Referring to a body mass index of 22 kg/m², the risk of graft loss was 1.088, 0.981, 1.003, and 1.685 for a body mass index of 18, 24, 28, and 40 kg/m², respectively. Body mass index with the lowest risk of patient death was 24.7 kg/m², and preferred body mass index range was 22-27 kg/m². Referring to a body mass index of 22 kg/m², the patient death risk was 1.115, 0.981, 1.032, and 2.634 for a body mass index of 18, 24, 28, and 40 kg/m², respectively. J-shaped relationships were observed between body mass index and acute rejection, delayed graft function, primary graft nonfunction, and de novo diabetes. Pair-wise comparisons showed that higher body mass index was also a risk factor for cardiovascular diseases, hypertension, infection, longer length of hospital stay, and lower estimated glomerular filtration rate level.

CONCLUSION

Underweight and severe obesity at transplantation are associated with a significantly increased risk of graft loss and patient death. A target body mass index at kidney transplantation is 22-27 kg/m².

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Vranic G, Cooper M. But Why Weight: Understanding the Implications of Obesity in Kidney Transplant. Semin Nephrol 2021;41:380-391. [PMID: 34715967 DOI: 10.1016/j.semnephrol.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]

Grèze C, Pereira B, Boirie Y, Guy L, Millet C, Clerfond G, Garrouste C, Heng AE. Impact of obesity in kidney transplantation: a prospective cohort study from French registries between 2008 and 2014. Nephrol Dial Transplant 2021;37:584-594. [PMID: 34610103 DOI: 10.1093/ndt/gfab277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Indexed: 11/14/2022] Open

Kermansaravi M, Davarpanah Jazi AH, Talebian P, Rokhgireh S, Kabir A, Pazouki A. Bariatric surgery in transplant recipients: A narrative review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021;26:44. [PMID: 34484376 PMCID: PMC8384002 DOI: 10.4103/jrms.jrms_631_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/20/2020] [Accepted: 02/09/2021] [Indexed: 11/11/2022]

Palamuthusingam D, Singh A, Palamuthusingam P, Hawley CM, Pascoe EM, Johnson DW, Fahim M. Postoperative outcomes after bariatric surgery in patients on chronic dialysis: A systematic review and meta-analysis. Obes Res Clin Pract 2021;15:473-484. [PMID: 34233859 DOI: 10.1016/j.orcp.2021.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/20/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022]

García-Carro C, Vergara A, Bermejo S, Azancot MA, Sellarés J, Soler MJ. A Nephrologist Perspective on Obesity: From Kidney Injury to Clinical Management. Front Med (Lausanne) 2021;8:655871. [PMID: 33928108 PMCID: PMC8076523 DOI: 10.3389/fmed.2021.655871] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open

Prudhomme T, Lesourd M, Roumiguié M, Gamé X, Soulié M, Del Bello A, Kamar N, Sallusto F, Doumerc N. [Living-donor robotic-assisted kidney transplantation: French academic center experience]. Prog Urol 2021;31:539-554. [PMID: 33612444 DOI: 10.1016/j.purol.2020.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/01/2022]

Increased Frequency of Nutritional Counseling Improves Weight Status and Lipids in Renal Transplant Recipients. TOP CLIN NUTR 2021. [DOI: 10.1097/tin.0000000000000231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]

Effects of Obesity on Postoperative Complications and Graft Survival After Kidney Transplantation. Transplant Proc 2020;52:3153-3159. [DOI: 10.1016/j.transproceed.2020.02.178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 02/13/2020] [Indexed: 02/06/2023]

Ahmadpoor P, Seifi B, Zoghy Z, Bakhshi E, Dalili N, Poorrezagholi F, Nafar M. Time-Varying Covariates and Risk Factors for Graft Loss in Kidney Transplantation. Transplant Proc 2020;52:3069-3073. [PMID: 32694057 DOI: 10.1016/j.transproceed.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/27/2020] [Accepted: 06/04/2020] [Indexed: 10/23/2022]

Ku E, Whelan AM, McCulloch CE, Lee B, Niemann CU, Roll GR, Grimes BA, Johansen KL. Weighing the waitlist: Weight changes and access to kidney transplantation among obese candidates. PLoS One 2020;15:e0242784. [PMID: 33253253 PMCID: PMC7703917 DOI: 10.1371/journal.pone.0242784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022] Open

Abstract

High body mass index is a known barrier to access to kidney transplantation in patients with end-stage kidney disease. The extent to which weight and weight changes affect access to transplantation among obese candidates differentially by race/ethnicity has received little attention. We included 10 221 obese patients waitlisted for kidney transplantation prior to end-stage kidney disease onset between 1995–2015. We used multinomial logistic regression models to examine the association between race/ethnicity and annualized change in body mass index (defined as stable [-2 to 2 kg/m²/year], loss [>2 kg/m²/year] or gain [>2 kg/m²/year]). We then used Fine-Gray models to examine the association between weight changes and access to living or deceased donor transplantation by race/ethnicity, accounting for the competing risk of death. Overall, 29% of the cohort lost weight and 7% gained weight; 46% received a transplant. Non-Hispanic blacks had a 24% (95% CI 1.12–1.38) higher odds of weight loss and 22% lower odds of weight gain (95% CI 0.64–0.95) compared with non-Hispanic whites. Hispanics did not differ from whites in their odds of weight loss or weight gain. Overall, weight gain was associated with lower access to transplantation (HR 0.88 [95% CI 0.79–0.99]) compared with maintenance of stable weight, but weight loss was not associated with better access to transplantation (HR 0.96 [95% CI 0.90–1.02]), although this relation differed by baseline body mass index and for recipients of living versus deceased donor organs. For example, weight loss was associated with improved access to living donor transplantation (HR 1.24 [95% CI 1.07–1.44]) in whites but not in blacks or Hispanics. In a cohort of obese patients waitlisted before dialysis, blacks were more likely to lose weight and less likely to gain weight compared with whites. Weight loss was only associated with improved access to living donor transplantation among whites. Further studies are needed to understand the reasons for the observed associations.

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Is recipient's body mass index a determinant of short term complications in early renal transplantation? Prog Urol 2020;30:663-674. [DOI: 10.1016/j.purol.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 11/18/2022]

Di Cocco P, Okoye O, Almario J, Benedetti E, Tzvetanov IG, Spaggiari M. Obesity in kidney transplantation. Transpl Int 2020;33:581-589. [PMID: 31667905 DOI: 10.1111/tri.13547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/03/2019] [Accepted: 10/28/2019] [Indexed: 12/14/2022]

Diwan TS, Cuffy MC, Linares-Cervantes I, Govil A. Impact of obesity on dialysis and transplant and its management. Semin Dial 2020;33:279-285. [PMID: 32277512 DOI: 10.1111/sdi.12876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]

Warzyszyńska K, Zawistowski M, Karpeta E, Ostaszewska A, Jonas M, Kosieradzki M. Early Postoperative Complications and Outcomes of Kidney Transplantation in Moderately Obese Patients. Transplant Proc 2020;52:2318-2323. [PMID: 32252995 DOI: 10.1016/j.transproceed.2020.02.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/13/2020] [Indexed: 12/27/2022]

Baglien B, Ngaage LM, Elegbede A, Gebran SG, Nam AJ, Niederhaus S, Scalea JR, Bromberg JS, Bartlett ST, Rasko YM. Teamwork Makes the Dream Work: Maximizing Surgical Intervention at the Time of Living Donor Renal Transplantation. Transplant Proc 2020;52:731-736. [DOI: 10.1016/j.transproceed.2020.01.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/02/2020] [Indexed: 01/06/2023]

Hollis J, Corden E, Williams PF. Longitudinal Evaluation of a Weight Reduction Program for Patients on Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080502503s40] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open

The Use of GLP1R Agonists for the Treatment of Type 2 Diabetes in Kidney Transplant Recipients. Transplant Direct 2020;6:e524. [PMID: 32095510 PMCID: PMC7004635 DOI: 10.1097/txd.0000000000000971] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 12/16/2022] Open

Orthostatic Renal Transplant Compression Following Weight Gain Leading to Acute Kidney Injury. Transplant Proc 2020;52:153-156. [PMID: 31924406 DOI: 10.1016/j.transproceed.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/02/2019] [Indexed: 11/23/2022]

Beaudreuil S, Iglicki F, Ledoux S, Elias M, Obada ENN, Hebibi H, Durand E, Charpentier B, Coffin B, Durrbach A. Efficacy and Safety of Intra-gastric Balloon Placement in Dialyzed Patients Awaiting Kidney Transplantation. Obes Surg 2019;29:713-720. [PMID: 30474792 DOI: 10.1007/s11695-018-3574-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]

Ostaszewska A, Wszola M, Olszewska N, Karpeta E, Serwanska-Swietek M, Kuthan R, Kawecki D, Berman A, Domagała P, Kwiatkowski A, Chmura A. Reoperation in Early Kidney Post-transplant Period as a Strong Risk Factor of Surgical Site Infection Occurrence. Transplant Proc 2019;51:2724-2730. [PMID: 31477417 DOI: 10.1016/j.transproceed.2019.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 04/25/2019] [Accepted: 05/08/2019] [Indexed: 11/29/2022]

Obesity in Kidney Transplantation: Impact on Transplant Candidates, Recipients, and Donors. Cardiol Rev 2019;27:63-72. [PMID: 29870421 DOI: 10.1097/crd.0000000000000216] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]

The Evolution of Kidney Transplantation Surgery Into the Robotic Era and Its Prospects for Obese Recipients. Transplantation 2019;102:1650-1665. [PMID: 29916987 DOI: 10.1097/tp.0000000000002328] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]

Abdominal wall complications following renal transplantation in adult recipients - factors associated with interventional management in one unit. BMC Surg 2019;19:10. [PMID: 30665387 PMCID: PMC6341541 DOI: 10.1186/s12893-019-0468-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/02/2019] [Indexed: 12/13/2022] Open

Heng AE, Aniort J, Pereira B, Fervenza F, Boirie Y, Prieto M. Renal Transplant in Obese Patients and Impact of Weight Loss Before Surgery on Surgical and Medical Outcomes: A Single-Center Cohort Study. EXP CLIN TRANSPLANT 2019;17:604-612. [PMID: 30602363 DOI: 10.6002/ect.2018.0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]

Kaur K, Jun D, Grodstein E, Singer P, Castellanos L, Teperman L, Molmenti E, Fahmy A, Frank R, Infante L, Sethna CB. Outcomes of underweight, overweight, and obese pediatric kidney transplant recipients. Pediatr Nephrol 2018;33:2353-2362. [PMID: 30136105 DOI: 10.1007/s00467-018-4038-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/31/2018] [Accepted: 07/31/2018] [Indexed: 01/02/2023]

Abstract

BACKGROUND

Obesity is a risk factor for poor transplant outcomes in the adult population. The effect of pre-transplant weight on pediatric kidney transplantation is conflicting in the existing literature.

METHODS

Data was collected from the Organ Procurement and Transplantation Network (OPTN) database on recipients aged 2-21 years who received a kidney-only transplant from 1987 to 2017. Recipients were categorized into underweight, normal, overweight, and obese cohorts. Using adjusted regression models, the relationship between recipient weight and various graft outcomes (delayed graft function [DGF], acute rejection, prolonged hospitalization, graft failure, mortality) was examined.

RESULTS

18,261 transplant recipients (mean age 14.1 ± 5.5 years) were included, of which 8.7% were underweight, 14.8% were overweight, and 15% were obese. Obesity was associated with greater odds of DGF (OR 1.3 95% CI 1.13-1.49, p < 0.001), acute rejection (OR 1.23 95% CI 1.06-1.43, p < 0.01), and prolonged hospitalization (OR 1.35 95% CI 1.17-1.54, p < 0.001) as well as greater hazard of graft failure (HR 1.13 95% CI 1.05-1.22, p = 0.001) and mortality (HR 1.19 95% CI 1.05-1.35, p < 0.01). The overweight cohort had an increased risk of graft failure (HR 1.08 95% CI 1.001-1.16, p = 0.048) and increased odds of DGF (OR 1.2 95% CI 1.04-1.38, p = 0.01) and acute rejection (OR 1.18 95% CI 1.01-1.38, p = 0.04). When stratified by age group, the increased risk was realized among younger and older age groups for obese and overweight. Underweight had lower risk of 1-year graft failure (HR 0.82 95% CI 0.71-0.94, p < 0.01), overall graft failure in the 13-17-yr. age group (HR 0.84 95% CI 0.72-0.99, p = 0.03) and acute rejection in the 2-5-yr. age group (OR 0.24 95% CI 0.09-0.66, p < 0.01).

CONCLUSION

Pre-transplant weight status and age impact pediatric kidney transplant outcomes. Recipient underweight status seems to be protective against adverse outcomes while overweight and obesity may lead to poorer graft and patient outcomes.

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Affiliation(s)

Kiranjot Kaur Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Daniel Jun Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Elliot Grodstein Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Pamela Singer Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Laura Castellanos Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Lewis Teperman Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Ernesto Molmenti Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Ahmed Fahmy Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Rachel Frank Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Lulette Infante Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA
Christine B Sethna Department of Pediatrics, Division of Nephrology and Kidney Transplantation, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA.

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[Impact of obesity in kidney transplantation: Monocentric cohort study and review of the literature]. Nephrol Ther 2018;14:454-461. [PMID: 29602732 DOI: 10.1016/j.nephro.2018.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 12/21/2017] [Accepted: 01/14/2018] [Indexed: 01/07/2023]

Yazbek DC, Carvalho AB, Barros CS, Medina Pestana JO, Rochitte CE, dos Santos Filho RD, Canziani MEF. Is there relationship between epicardial fat and cardiovascular parameters in incident kidney transplant patients? A post-hoc analysis. PLoS One 2018;13:e0191009. [PMID: 29466361 PMCID: PMC5821310 DOI: 10.1371/journal.pone.0191009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/27/2017] [Indexed: 11/19/2022] Open

Kim Y, Jung AD, Dhar VK, Tadros JS, Schauer DP, Smith EP, Hanseman DJ, Cuffy MC, Alloway RR, Shields AR, Shah SA, Woodle ES, Diwan TS. Laparoscopic sleeve gastrectomy improves renal transplant candidacy and posttransplant outcomes in morbidly obese patients. Am J Transplant 2018;18:410-416. [PMID: 28805345 DOI: 10.1111/ajt.14463] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/04/2017] [Accepted: 08/04/2017] [Indexed: 01/25/2023]

Ladhani M, Craig JC, Irving M, Clayton PA, Wong G. Obesity and the risk of cardiovascular and all-cause mortality in chronic kidney disease: a systematic review and meta-analysis. Nephrol Dial Transplant 2017;32:439-449. [PMID: 27190330 DOI: 10.1093/ndt/gfw075] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/12/2016] [Indexed: 01/18/2023] Open

Taha M, Davis NF, Power R, Mohan P, Forde J, Smyth G, Little DM. Increased mid-abdominal circumference is a predictor for surgical wound complications in kidney transplant recipients: A prospective cohort study. Clin Transplant 2017;31. [PMID: 28295629 DOI: 10.1111/ctr.12960] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2017] [Indexed: 02/05/2023]

Gheith O, Al-Otaibi T, Halim MA, Mahmoud T, Mosaad A, Yagan J, Zakaria Z, Rida S, Nair P, Hassan R. Bariatric Surgery in Renal Transplant Patients. EXP CLIN TRANSPLANT 2017;15:164-169. [PMID: 28260459 DOI: 10.6002/ect.mesot2016.p35] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]

Ouayogodé MH. Effectiveness of weight loss intervention in highly-motivated people. ECONOMICS AND HUMAN BIOLOGY 2016;23:263-282. [PMID: 27816867 DOI: 10.1016/j.ehb.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/26/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]

Abstract

A variety of approaches have been implemented to address the rising obesity epidemic, with limited success. I consider the success of weight loss efforts among a group of highly motivated people: those required to lose weight in order to qualify for a life-saving kidney transplantation. Out of 246 transplantation centers, I identified 156 (63%) with explicit body mass index (BMI) requirements for transplantation, ranging from 30 to 50kg/m². Using the United States national registry of transplant candidates, I examine outcomes for 29,608 obese deceased-donor transplant recipients between 1990 and 2010. I use value-added models to deal with potential endogeneity of center choice, in addition to correcting for sample selection bias arising from focusing on transplant recipients. Outcome variables measure BMI level and weight change (in BMI) between initial listing and transplantation. I hypothesize that those requiring weight loss to qualify for kidney transplantation will be most likely to lose weight. I find that the probability of severe and morbid obesity (BMI≥35kg/m²) decreases by 4 percentage points and the probability of patients achieving any weight loss increases by 22 percentage points at centers with explicit BMI eligibility criteria. Patients are also 13 percentage points more likely to accomplish clinically relevant weight loss of at least 5% of baseline BMI by transplantation at these centers. Nonetheless, I estimate an average decrease in BMI of only 1.7kg/m² for those registered at centers with BMI requirements. Further analyses suggest stronger intervention effects for patients whose BMI at listing exceeds thresholds as the distance from their BMI to the thresholds increases. Even under circumstances with great potential returns for weight loss, transplant candidates exhibit modest weight-loss. This suggests that, even in high-stakes environments, weight loss remains a challenge for the obese, and altering individual incentives may not be sufficient.

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Schachtner T, Stein M, Reinke P. Increased alloreactivity and adverse outcomes in obese kidney transplant recipients are limited to those with diabetes mellitus. Transpl Immunol 2016;40:8-16. [PMID: 27903445 DOI: 10.1016/j.trim.2016.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/18/2016] [Accepted: 11/23/2016] [Indexed: 12/20/2022]

La transplantation rénale et ses défis. Prog Urol 2016;26:1001-1044. [PMID: 27720627 DOI: 10.1016/j.purol.2016.09.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 01/09/2023]

Yaegashi M, Jean R, Zuriqat M, Noack S, Homel P. Outcome of Morbid Obesity in the Intensive Care Unit. J Intensive Care Med 2016;20:147-54. [PMID: 15888902 DOI: 10.1177/0885066605275314] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]

Camilleri B, Bridson JM, Sharma A, Halawa A. From chronic kidney disease to kidney transplantation: The impact of obesity and its treatment modalities. Transplant Rev (Orlando) 2016;30:203-11. [PMID: 27534874 DOI: 10.1016/j.trre.2016.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/25/2016] [Accepted: 07/22/2016] [Indexed: 12/19/2022]

Okumi M, Unagami K, Tachibana H, Hirai T, Ishida H, Tanabe K. Association between body mass index and outcomes in Japanese living kidney transplant recipients: The role of sex differences. Int J Urol 2016;23:776-84. [DOI: 10.1111/iju.13135] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 05/05/2016] [Indexed: 12/30/2022]