Edmund Huang1, Suphamai Bunnapradist. 1. University of California, Los Angeles School of Medicine, Department of Medicine, Division of Nephrology, Kidney and Pancreas Transplant Research Program, Los Angeles, Calif., USA.
Abstract
BACKGROUND/AIMS: We examined post-transplant survival among obese kidney candidates who were temporarily designated waitlist inactive (status 7) due to their weight. METHODS: Using OPTN/United Network for Organ Sharing data, patient and graft survival of adult status 7 recipients with a registration body mass index (BMI) ≥30 kg/m(2) (n = 328) were compared to all others (controls; n = 74,066). Status 7 recipients were then matched to controls to assess whether pre-transplant weight loss was associated with a survival benefit. RESULTS: Median BMI at registration (38 vs. 27 kg/m(2), p < 0.001) and transplant (36 vs. 27 kg/m(2), p < 0.001) and reduction in BMI while waitlisted (-5.0 vs. 0.0%, p < 0.001) were higher among status 7 than controls. Patient (status 7: 87.3%; control: 89.3%; p = 0.90) and graft survival (status 7: 82.9%; control: 81.6%; p = 0.75) were similar over 4 years. There was no association between status 7 and mortality (HR 0.96, 95% CI 0.59-1.57) or graft loss (HR 0.95, 95% CI 0.66-1.38) in the overall population nor between matched status 7 recipients and controls (patient survival: 86.0 vs. 87.5%, p = 0.20; graft survival: 82.6 vs. 77.2%, p = 0.61). CONCLUSION: Among obese status 7 kidney candidates previously considered too obese for transplant, patient and graft survival were comparable to the general transplant population. No difference in survival was observed with pre-transplant weight loss.
BACKGROUND/AIMS: We examined post-transplant survival among obese kidney candidates who were temporarily designated waitlist inactive (status 7) due to their weight. METHODS: Using OPTN/United Network for Organ Sharing data, patient and graft survival of adult status 7 recipients with a registration body mass index (BMI) ≥30 kg/m(2) (n = 328) were compared to all others (controls; n = 74,066). Status 7 recipients were then matched to controls to assess whether pre-transplant weight loss was associated with a survival benefit. RESULTS: Median BMI at registration (38 vs. 27 kg/m(2), p < 0.001) and transplant (36 vs. 27 kg/m(2), p < 0.001) and reduction in BMI while waitlisted (-5.0 vs. 0.0%, p < 0.001) were higher among status 7 than controls. Patient (status 7: 87.3%; control: 89.3%; p = 0.90) and graft survival (status 7: 82.9%; control: 81.6%; p = 0.75) were similar over 4 years. There was no association between status 7 and mortality (HR 0.96, 95% CI 0.59-1.57) or graft loss (HR 0.95, 95% CI 0.66-1.38) in the overall population nor between matched status 7 recipients and controls (patient survival: 86.0 vs. 87.5%, p = 0.20; graft survival: 82.6 vs. 77.2%, p = 0.61). CONCLUSION: Among obese status 7 kidney candidates previously considered too obese for transplant, patient and graft survival were comparable to the general transplant population. No difference in survival was observed with pre-transplant weight loss.
Authors: Elaine Ku; Adrian M Whelan; Charles E McCulloch; Brian Lee; Claus U Niemann; Garrett R Roll; Barbara A Grimes; Kirsten L Johansen Journal: PLoS One Date: 2020-11-30 Impact factor: 3.240
Authors: Gabriel C Oniscu; Daniel Abramowicz; Davide Bolignano; Ilaria Gandolfini; Rachel Hellemans; Umberto Maggiore; Ionut Nistor; Stephen O'Neill; Mehmet Sukru Sever; Muguet Koobasi; Evi V Nagler Journal: Nephrol Dial Transplant Date: 2021-12-24 Impact factor: 5.992