AJT The Survival Benefit of Kidney Transplantation in Obese Patients.
- Gill JS, Lan J, Dong J, et al.
- The Survival Benefit of Kidney Transplantation in Obese Patients. [JOURNAL ARTICLE]
- Am J Transplant 2013 Jul 25.
Obese patients have a decreased risk of death on dialysis but an increased risk of death after transplantation, and may derive a lower survival benefit from transplantation. Using data from the United States between 1995 and 2007 and multivariate non-proportional hazards analyses we determined the relative risk of death in transplant recipients grouped by body mass index (BMI) compared to wait-listed candidates with the same BMI (n = 208 498). One year after transplantation the survival benefit of transplantation varied by BMI: Standard criteria donor transplantation was associated with a 48% reduction in the risk of death in patients with BMI ≥ 40 kg/m(2) but a ≥66% reduction in patients with BMI < 40 kg/m(2) . Living donor transplantation was associated with ≥66% reduction in the risk of death in all BMI groups. In sub-group analyses, transplantation from any donor source was associated with a survival benefit in obese patients ≥50 years, and diabetic patients, but a survival benefit was not demonstrated in Black patients with BMI ≥ 40 kg/m(2) . Although most obese patients selected for transplantation derive a survival benefit, the benefit is lower when BMI is ≥40 kg/m(2) , and uncertain in Black patients with BMI ≥ 40 kg/m(2) .
http://www.unboundmedicine.com/medline/citation/23890325/The_Survival_Benefit_of_Kidney_Transplantation_in_Obese_Patients_
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