Y Foucher1,2, M Lorent3,4,5, L Albano6, S Roux3, V Pernin7, M Le Quintrec7, C Legendre8, F Buron9, E Morelon9, S Girerd10, M Ladrière10, D Glotz11, C Lefaucher11, C Kerleau4,5, J Dantal4,5,12, J Branchereau4,5,12, M Giral4,5,12. 1. INSERM UMR 1246 - SPHERE, Nantes University, Tours University, Nantes, France. Yohann.Foucher@univ-nantes.fr. 2. Centre Hospitalier Universitaire de Nantes, Nantes, France. Yohann.Foucher@univ-nantes.fr. 3. INSERM UMR 1246 - SPHERE, Nantes University, Tours University, Nantes, France. 4. Centre Hospitalier Universitaire de Nantes, Nantes, France. 5. CRTI UMR 1064, Inserm, Université de Nantes; ITUN, CHU Nantes; RTRS Centaur, Nantes, France. 6. Department of Nephrology and Renal Transplantation, Hospital Pasteur, Nice, France. 7. Nephrology, Dialysis and Transplantation Department, Lapeyronie University Hospital, Montpellier, France. 8. Kidney Transplant Center, Necker University Hospital, APHP, RTRS « Centaure », Paris Descartes and Sorbonne Paris Cité Universities, Paris, France. 9. Nephrology, Transplantation and Clinical Immunology Department, RTRS « Centaure », Edouard Herriot University Hospital, Hospices Civils, Lyon, France. 10. Renal Transplantation Department, Brabois University Hospital, Nancy, France. 11. Department of Nephrology and Renal Transplantation, CHU Paris-GH St-Louis Lariboisière F. Widal, Paris, France. 12. Centre d'Investigation Clinique en Biothérapie, Centre Hospitalier Universitaire de Nantes, Nantes, France.
Abstract
BACKGROUND: Whilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort. METHODS: In this study, cause-specific Cox models were used to study patient and graft survival and several other time-to-event measures. Logistic regressions were performed to study surgical complications at 30 days post-transplantation as well as delayed graft function. RESULTS: Among the 4691 included patients, 747 patients were considered obese with a BMI level greater than 30 kg/m2. We observed a higher mortality for obese recipients (HR = 1.37, p = 0.0086) and higher risks of serious bacterial infections (HR = 1.24, p = 0.0006) and cardiac complications (HR = 1.45, p < 0.0001). We observed a trend towards death censored graft survival (HR = 1.22, p = 0.0666) and no significant increased risk of early surgical complications. CONCLUSIONS: We showed that obesity increased the risk of death and serious bacterial infections and cardiac complications in obese French kidney transplant recipients. Further epidemiologic studies aiming to compare obese recipients versus obese candidates remaining on dialysis are needed to improve the guidelines for obese patient transplant allocation.
BACKGROUND: Whilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort. METHODS: In this study, cause-specific Cox models were used to study patient and graft survival and several other time-to-event measures. Logistic regressions were performed to study surgical complications at 30 days post-transplantation as well as delayed graft function. RESULTS: Among the 4691 included patients, 747 patients were considered obese with a BMI level greater than 30 kg/m2. We observed a higher mortality for obese recipients (HR = 1.37, p = 0.0086) and higher risks of serious bacterial infections (HR = 1.24, p = 0.0006) and cardiac complications (HR = 1.45, p < 0.0001). We observed a trend towards death censored graft survival (HR = 1.22, p = 0.0666) and no significant increased risk of early surgical complications. CONCLUSIONS: We showed that obesity increased the risk of death and serious bacterial infections and cardiac complications in obese French kidney transplant recipients. Further epidemiologic studies aiming to compare obese recipients versus obese candidates remaining on dialysis are needed to improve the guidelines for obese patient transplant allocation.
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