Get access

Kidney Transplantation in the Obese Transplant Candidates: To Transplant or Not To Transplant?

Authors

  • Phuong-Thu T. Pham,

    1. Department of Medicine, Nephrology Division, Kidney Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California
    Search for more papers by this author
  • Gabriel M. Danovitch,

    1. Department of Medicine, Nephrology Division, Kidney Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California
    Search for more papers by this author
  • Phuong-Chi T. Pham

    Corresponding author
    1. Department of Medicine, Division of Nephrology and Hypertension, UCLA-Olive View Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California
    • Department of Medicine, Nephrology Division, Kidney Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California
    Search for more papers by this author

Address correspondence to: Phuong-Thu T. Pham, MD., Department of Medicine, Nephrology Division, Kidney Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, e-mail: ppham@mednet.ucla.edu.

Abstract

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.

Get access to the full text of this article

Ancillary