Marie Fellmann1, Loïc Balssa2, Elise Clément3, Pierre Frey4, Alexandre Frontczak3, Stéphane Bernardini2, Éric Chabannes2, Guillaume Guichard2, Hugues Bittard3, François Kleinclauss3. 1. Service d'Urologie, Andrologie et Transplantation Rénale, CHU Besançon, France; Université de Franche-Comté, Besançon, France. Electronic address: mariefellmann@hotmail.fr. 2. Service d'Urologie, Andrologie et Transplantation Rénale, CHU Besançon, France. 3. Service d'Urologie, Andrologie et Transplantation Rénale, CHU Besançon, France; Université de Franche-Comté, Besançon, France. 4. Service de Cardiologie, CHR Annecy, France.
Abstract
OBJECTIVE: The objective of this study was to analyze the effects of obesity on postoperative complications and patient and graft survival after kidney transplantation. METHODS: We retrospectively included 506 patients who received a kidney transplant in our center during eleven years. Obesity was defined by a body mass index ≥ 30 kg/m2 based on World Health Organization criteria. Using univariate and multivariate analyses, we evaluated the impact of obesity on surgical complications according to the Clavien-Dindo classification up to 30 days after surgery. The impact of obesity on graft and patient survival was assessed using a Cox proportional regression model. RESULTS: Seventy-one patients were obese (14%), and mean follow-up was 63.1 months (59.7-66.5). By multivariable analysis, obesity was associated with delayed graft function (hazard ratio [HR] = 2.60 [1.31-5.02], P = .004). Obesity was not associated with surgical complications, but cardiovascular history was (HR = 1.68 [1.09-2.99], P = .048). By Cox regression analysis, obesity was significantly associated with a higher risk of graft loss (HR = 1.55 [1.06-2.99], P = .042) but not with patient survival (HR = 1.82 [0.88-3.79], P = .106). CONCLUSION: Obesity was associated with delayed graft function and graft loss. However, it was not associated with surgical complications. Kidney transplantation remains the best therapy for obese patients suffering from end-stage renal disease, despite shorter graft survival.
OBJECTIVE: The objective of this study was to analyze the effects of obesity on postoperative complications and patient and graft survival after kidney transplantation. METHODS: We retrospectively included 506 patients who received a kidney transplant in our center during eleven years. Obesity was defined by a body mass index ≥ 30 kg/m2 based on World Health Organization criteria. Using univariate and multivariate analyses, we evaluated the impact of obesity on surgical complications according to the Clavien-Dindo classification up to 30 days after surgery. The impact of obesity on graft and patient survival was assessed using a Cox proportional regression model. RESULTS: Seventy-one patients were obese (14%), and mean follow-up was 63.1 months (59.7-66.5). By multivariable analysis, obesity was associated with delayed graft function (hazard ratio [HR] = 2.60 [1.31-5.02], P = .004). Obesity was not associated with surgical complications, but cardiovascular history was (HR = 1.68 [1.09-2.99], P = .048). By Cox regression analysis, obesity was significantly associated with a higher risk of graft loss (HR = 1.55 [1.06-2.99], P = .042) but not with patient survival (HR = 1.82 [0.88-3.79], P = .106). CONCLUSION:Obesity was associated with delayed graft function and graft loss. However, it was not associated with surgical complications. Kidney transplantation remains the best therapy for obesepatients suffering from end-stage renal disease, despite shorter graft survival.