What is a Renal Transplant?
A renal transplant
is a procedure where a
kidney from a living donor or cadaver is surgically placed into a person whose
kidneys have failed and no longer function. A renal transplant is usually the
last option for a person with severe kidney disease.
What is Body Mass Index (BMI)?
Body mass index (BMI) is a measure for adults
to check if they have an ideal body weight in proportion to their height.
- a healthy BMI is in the range of
- BMI in the
range of 25-29.9 is considered overweight
- BMI in the range
of 30-39.9 is considered obese
- BMI higher than 40 is
BMI lower than 18.5 is underweight.
Influence of Body Mass Index on Renal Transplant Outcomes
Obesity is associated with several conditions
like type II diabetes
, hypertension, and high cholesterol
levels. Therefore, it is possible that obese patients receiving a kidney
transplant may be exposed to more complications during and after the
transplant, which raises the question whether obese patients should be advised
transplantation at all.
In the most recent study on BMI and renal
transplant outcomes published in May 2015, researchers Lafranca, IJermans,
Betjes and Dor systematically evaluated the outcome of renal transplant and
graft survival from data obtained from patients with low and high BMI.
The researchers conducted detailed searches in
databases like MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and
CENTRAL (the Cochrane Library 2014, issue 8). They included 56 studies, and
extracted data from more than 209,000 renal transplant recipients.
After analysis of the data obtained from the
study, the researchers found that patients with a low BMI performed better
following the renal transplant as compared to those with high BMI with respect
to the following parameters:
- Delayed graft function
- 1-, 2- and 3-year graft survival
infection and dehiscence (Wound dehiscence is a surgical complication where the
wound ruptures along the sutures.
- NODAT (New-onset
diabetes after transplantation)
- Length of hospital stay
hernia. Incisional hernia refers to a hernia caused at the site of an
incompletely healed surgical incision.
Based on their results, the researchers showed
significant benefits for low BMI (<30) transplant recipients. They therefore
concluded that ESRD patients with a BMI >30 should lose weight prior to
renal transplantation. In case this is not achieved through common procedures,
they could be advised
However, this does not mean that obese
individuals cannot undergo renal transplantation. The risk for complications
following renal transplantation should be weighed against the benefits of the
procedure in these individuals, and the patients should be advised accordingly.