title: Restricting kidney transplant wait-listing for obese patients: let's stop defending the indefensible.
abstract: The allocation of limited medical resources represents an ethical dilemma that continues to generate lively debates. While the allocation of allografts to wait-listed patients is done in a transparent manner, with its rules open to public debate and prone to continuous improvement, the practice of wait-listing is not centrally regulated, and its rules are often less scrutinized. Denial of kidney transplant wait-listing to obese individuals has been a common practice by most transplant centers. On the face of it, this practice is justified by commonly accepted ethical standards, yet there is now mounting evidence that these justifications do not withstand closer scrutiny. A candid and open debate in the Nephrology and Transplant community is needed to examine the true motivations that underlie the practice of denying wait-listing to obese individuals, and to find a solution that is truly in the best interest of our patients.
authors.affiliation: University of Tennessee Health Science Center, Memphis, Tennessee; Memphis VA Medical Center, Memphis, Tennessee.
authors.forename: Csaba P
authors.initials: CP
authors.lastname: Kovesdy
authors.forename: Miklos Z
authors.initials: MZ
authors.lastname: Molnar
mesh_terms: D017046:Cost Savings; D006801:Humans; D016030:Kidney Transplantation; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D019984:Quality Indicators, Health Care; D016079:Refusal to Treat / Q000941:ethics*; D040841:Resource Allocation / Q000941:ethics; D014019:Tissue Donors / Q000600:supply & distribution; D014850:Waiting Lists; D015431:Weight Loss