title: Increased mid-abdominal circumference is a predictor for surgical wound complications in kidney transplant recipients: A prospective cohort study.
abstract: Kidney transplant recipients are at an increased risk of developing surgical site wound complications due to their immunosuppressed status. We aimed to determine whether increased mid-abdominal circumference (MAC) is predictive for wound complications in transplant recipients. A prospective study was performed on all kidney transplant recipients from October 2014 to October 2015. "Controls" consisted of kidney transplant recipients without a surgical site wound complication and "cases" consisted of recipients that developed a wound complication. In total, 144 patients underwent kidney transplantation and 107 patients met inclusion criteria. Postoperative wound complications were documented in 28 (26%) patients. Patients that developed a wound complication had a significantly greater MAC, body mass index (BMI), and body weight upon renal transplantation (P<.001, P=.011, and P=.011, respectively). On single and multiple logistic regression analyses, MAC was a significant predictor for developing a surgical wound complication (P=.02). Delayed graft function and a history of preformed anti-HLA antibodies were also predictive for surgical wound complications (P=.003 and P=.014, respectively). Increased MAC is a significant predictor for surgical wound complications in kidney transplant recipients. Integrating clinical methods for measuring visceral adiposity may be useful for stratifying kidney transplant recipients with an increased risk of a surgical wound complication.
authors.affiliation: Department of Transplant Surgery and Urology, Beaumont hospital, Dublin, Ireland.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Taha
authors.affiliation: Department of Transplant Surgery and Urology, Beaumont hospital, Dublin, Ireland.
authors.forename: Niall F
authors.identifier: 0000-0002-5298-1475
authors.initials: NF
authors.lastname: Davis
authors.affiliation: Department of Transplant Surgery and Urology, Beaumont hospital, Dublin, Ireland.
authors.forename: Richard
authors.initials: R
authors.lastname: Power
authors.affiliation: Department of Transplant Surgery and Urology, Beaumont hospital, Dublin, Ireland.
authors.forename: Ponusamy
authors.initials: P
authors.lastname: Mohan
authors.affiliation: Department of Transplant Surgery and Urology, Beaumont hospital, Dublin, Ireland.
authors.forename: James
authors.initials: J
authors.lastname: Forde
authors.affiliation: Department of Transplant Surgery and Urology, Beaumont hospital, Dublin, Ireland.
authors.forename: Gordon
authors.initials: G
authors.lastname: Smyth
authors.affiliation: Department of Transplant Surgery and Urology, Beaumont hospital, Dublin, Ireland.
authors.forename: Dilly M
authors.initials: DM
authors.lastname: Little
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000209:etiology; D055105:Waist Circumference
keywords: body mass index; mid-abdominal circumference; surgical wound complication