The application of body mass index-based eligibility criteria may represent an unjustified barrier to renal transplantation in people with obesity.
bariatric surgery
kidney transplantation
obesity
weight loss
Journal
Clinical obesity
ISSN: 1758-8111
Titre abrégé: Clin Obes
Pays: England
ID NLM: 101560587
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
revised:
07
12
2021
received:
06
09
2021
accepted:
11
12
2021
pubmed:
30
12
2021
medline:
11
3
2022
entrez:
29
12
2021
Statut:
ppublish
Résumé
The prevalence of both obesity and end-stage kidney disease is increasing. In many centres, obesity is considered a relative contraindication to kidney transplantation due to an association with short- and longer-term adverse outcomes. This leads to delayed transplant waitlisting and longer organ waiting times for people with obesity. This review evaluates whether intentional pre-transplant weight loss in people with obesity improves kidney transplant outcomes. There are currently no data showing that non-surgical weight loss of 10% or more improves graft or patient survival over 4-5 years. Outcomes from bariatric surgery cohorts have been generally neutral or favourable after pre-transplant weight loss of ~25%. Given the survival benefit of kidney transplantation compared to maintenance dialysis, and the difficulty of achieving and maintaining weight loss, the common practice of recommending weight loss to achieve arbitrary targets prior to waiting list activation needs to be carefully considered.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12505Subventions
Organisme : National Health and Medical Research Council
Informations de copyright
© 2021 World Obesity Federation.
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