Outcomes after renal transplantation of obese patients: a French cohort-based study
Abstract Background. Whilst there are numbers of publications comparing the relationship between the body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study was performed in French patients. Methods. In this study, cause-specific Cox models were used to study patients and graft survival and several other different times-to-event. 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 higher than 30 kg/m². We observed a higher mortality of 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 reported a trend with 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 French kidney transplant recipients. Further epidemiologic studies aiming to compare obese recipients versus obese candidates staying in dialysis are needed for improving the guidelines of access to transplantation of obese patients.