Early Postoperative Complications and Outcomes of Kidney Transplantation in Moderately Obese Patients

Transplant Proc. 2020 Oct;52(8):2318-2323. doi: 10.1016/j.transproceed.2020.02.110. Epub 2020 Apr 4.

Abstract

Background: Obese renal transplant recipients (body mass index [BMI] ≥30 kg/m2) are at risk of delayed graft function and postoperative complications, such as infections or delayed wound healing. There is also a tendency to exclude extremely obese patients from transplantation (KTx). Nonetheless, no association between obesity and increased mortality has been reported. The aim of this study is to evaluate the effect of BMI on the most common surgical and infectious complications after KTx.

Materials and methods: An observational study in 872 patients transplanted from 2010-2017 was conducted. Median BMI was 24.6 (13.9-34.3), and 8.3% of the group was obese. Patient records were searched for early postoperative complications: lymphocele or hematoma (>33 mL), urinary leakage, or urinary tract infection (UTI). Mann-Whitney U and χ2 or Fisher exact tests were used. P < .05 was considered statistically significant. The study complies with the Helsinki Congress and the Istanbul Declaration.

Results: Renal primary nonfunction was observed in 1.4% (12/872) of patients. Surgical or infectious complications occurred in 52.7% (453/860) of patients. No correlation between BMI and complication rate was noted. Complications were observed in 56.9% (41/72) of obese vs 52.3% (412/788) of nonobese patients (P = .448), including lymphocele in 15.3% vs 16.4% (P = .810), hematoma in 22.2% vs 19.2% (P = .530), urinary leakage in 1.4% vs 4.6% (P = .203), and UTI in 31.9% vs 32.9% (P = .873), respectively.

Conclusions: Recipient's BMI has no significant association with the most common surgical complications after KTx. There is no need to delay KTx in moderately obese patients.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Body Mass Index*
  • Female
  • Humans
  • Kidney
  • Kidney Diseases / etiology
  • Kidney Diseases / surgery*
  • Kidney Transplantation / adverse effects*
  • Lymphocele / epidemiology
  • Lymphocele / etiology
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Postoperative Period
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / etiology
  • Young Adult