1. Effects of Obesity on Postoperative Complications and Graft Survival After Kidney Transplantation
- Author
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Hugues Bittard, Marie Fellmann, Elise Clément, L. Balssa, Eric Chabannes, G. Guichard, Stéphane Bernardini, Pierre Frey, A. Frontczak, François Kleinclauss, Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de cardiologie, and Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,[SDV]Life Sciences [q-bio] ,030232 urology & nephrology ,Delayed Graft Function ,Disease ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,medicine ,Humans ,Obesity ,Kidney transplantation ,Retrospective Studies ,2. Zero hunger ,Transplantation ,Cardiovascular History ,business.industry ,Proportional hazards model ,Hazard ratio ,Graft Survival ,Middle Aged ,medicine.disease ,Kidney Transplantation ,3. Good health ,Surgery ,Treatment Outcome ,Kidney Failure, Chronic ,Graft survival ,Female ,business - 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.
- Published
- 2020
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