Transplant of the Obese Recipient

Transplant of the Obese Recipient

Swedish’s kidney transplant program is the only transplant center in Seattle that does not have a body mass index (BMI) cutoff for kidney transplant recipients. The BMI is calculated using an individual’s height and weight measurements.

Concern that obese (BMI of 30-40) and morbidly obese (BMI greater than 40) kidney transplant recipients have worse outcomes than non- obese recipients leads many transplant centers to deny them the benefit of kidney transplantation. It is our practice to evaluate obese and morbidly obese transplant candidates for transplantation under the same criteria used for non obese candidates.

Potential kidney transplant recipients at Swedish are evaluated on a case by case basis and selection is the result of a coordinated process which looks at the whole patient. In the case of obese and morbidly obese persons, the kidney transplant team works with physicians and bariatric surgeons from Swedish’s Weight Loss Services team to arrive at solutions that best fit our patient’s needs and ensure the best possible outcome.

Our Research

Swedish Transplant surgeons compared kidney transplant results of morbidly obese and non obese patients between 1995 and 2000 and published their findings in the American Journal of Surgery in 2004 (American Journal of Surgery – Volume 187, Issue 5, May 2004). They found that morbidly obese transplant recipients had similar survival rates as non obese recipients. While morbidly obese transplant recipients did have more complications and longer hospital stays, Swedish Transplant surgeons concluded that those reasons are not sufficient to deny morbidly obese persons the survival and quality-of-live advantages of kidney transplantation.

Complications

Obese and morbidly obese kidney transplant recipients are more likely to experience the following compared to non obese kidney transplant recipients:

  • Longer post-transplant hospital stay ( 6-8 days vs. 5-6 days )
  • Greater occurrence of hospital readmissions within first 6 months after transplant
  • Increase risk of incisional wound infection

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