title: Kidney Transplant Outcomes in the Super Obese: A National Study From the UNOS Dataset.
abstract: We evaluated outcomes of super-obese patients (BMI > 50) undergoing kidney transplantation in the US.
  
  
  
  We performed a review of 190 super-obese patients undergoing kidney transplantation from 1988 through 2013 using the UNOS dataset.
  
  
  
  Super-obese patients had a mean age of 45.7 years (21-75 years) and 111 (58.4 %) were female. The mean BMI of the super-obese group was 56 (range 50.0-74.2). A subgroup analysis demonstrated that patients with BMI > 50 had worse survival compared to any other BMI class. The 30-day perioperative mortality and length of stay was 3.7 % and 10.09 days compared to 0.8 % and 7.34 days in nonsuper-obese group. On multivariable analysis, BMI > 50 was an independent predictor of 30-day mortality, with a 4.6-fold increased risk of perioperative death. BMI > 50 increased the risk of delayed graft function and the length of stay by twofold. The multivariable analysis of survival showed a 78 % increased risk of death in this group. Overall patient survival for super-obese transplant recipients at 1, 3, and 5 years was 88, 82, and 76 %, compared to 96, 91, 86 % on patients transplanted with BMI < 50. A propensity score adjusted analysis further demonstrates significant worse survival rates in super-obese patients undergoing kidney transplantation.
  
  
  
  Super-obese patients had prolonged LOS and worse DGF rates. Perioperative mortality was increased 4.6-fold compared to patients with BMI < 50. In a subgroup analysis, super-obese patients who underwent kidney transplantation had significantly worse graft and patient survival compared to underweight, normal weight, and obesity class I, II, and III (BMI 40-50) patients.
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Kanthawar
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Mei
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Daily
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Jyotin
authors.initials: J
authors.lastname: Chandarana
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Malay
authors.initials: M
authors.lastname: Shah
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berger
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Ana Lia
authors.initials: AL
authors.lastname: Castellanos
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Francesc
authors.initials: F
authors.lastname: Marti
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA. rgeda2@uky.edu.|University of Kentucky Transplant Center, 800 Rose Street, C451, Lexington, KY, 40536-0293, USA. rgeda2@uky.edu.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gedaly
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D066264:Datasets as Topic; D051799:Delayed Graft Function; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000401:mortality*; D066027:Transplant Recipients; D014481:United States / Q000453:epidemiology; D055815:Young Adult