Kidney transplantation in obese patients
Kidney transplantation in obese patients作者机构：Division of Transfusion Medicine and Apheresis Department of Pathology and Laboratory Medicine University of California Irvine School of Medicine Division of Transplantation Department of Surgery University of California Irvine School of Medicine Division of Nephrology Department of Medicine University of California Irvine School of Medicine
出 版 物：《World Journal of Transplantation》 (世界移植杂志)
年 卷 期：2016年第6卷第1期
页 面：135-143页
学科分类：10[医学]
基 金：Supported by(In part)grants from:NIH-NCRR UL1 TR000153,KL2 TR000147 the Juvenile Diabetes Research Foundation International 17-2011-609
主 题：Body mass index Overweight Obese Kidney transplant Transplant complications Transplant outcomes Patient survival Graft survival
摘 要：The World Health Organization estimated that in 2014, over 600 million people met criteria for obesity. In 2011, over 30% of individuals undergoing kidney transplant had a body mass index(BMI) 35 kg/m^2 or greater. A number of recent studies have confirmed the relationship between overweight/obesity and important comorbidities in kidney transplant patients. As with non-transplant surgeries, the rate of wound and soft tissue complications are increased following transplant as is the incidence of delayed graft function. These two issues appear to contribute to longer length of stay compared to normal BMI. New onset diabetes after transplant and cardiac outcomes also appear to be increased in the obese population. The impact of obesity on patient survival after kidney transplantation remains controversial, but appears to mirror the impact of extremes of BMI in non-transplant populations. Early experience with(open and laparoscopic) Rouxen-Y gastric bypass and laparoscopic sleeve gastrectomy support excellent weight loss(in the range of 50%-60% excess weight lost at 1 year), but experts have recommended the need for further studies. Long term nutrient deficiencies remain a concern but in general, these procedures do not appear to adversely impact absorption of immunosuppressive medications. In this study, we review the literature to arrive at a better understanding of the risks related to renal transplantation among individuals with obesity.
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