Renal transplantation outcomes in obese patients: a French cohort-based study

Y. Foucher (1, 2) , Marine Lorent (2, 1, 3) , L. Albano (4) , S. Roux (1) , V. Pernin (5) , M. Le Quintrec (5) , C. Legendre (6, 7, 8, 9) , F. Buron (7, 10, 11) , E. Morelon (7, 10, 11) , S. Girerd (12) , M. Ladrière (12) , D. Glotz (13) , C. Lefaucher (13) , C. Kerleau (2, 3) , J. Dantal (2, 3) , J. Branchereau (2, 3) , M. Giral (2, 3)

1 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
2 CHU Nantes - Centre Hospitalier Universitaire de Nantes
3 U1064 Inserm - CRTI - Centre de Recherche en Transplantation et Immunologie
4 Pasteur Hospital
5 CHU - Hôpital Lapeyronie [Montpellier]
6 Hôpital Necker - Enfants Malades [AP-HP]
7 RTRS « Centaure »
8 UPD5 - Université Paris Descartes - Paris 5
9 USPC - Université Sorbonne Paris Cité
10 Hôpital Edouard Herriot [CHU - HCL]
11 HCL - Hospices Civils de Lyon
12 Service de Transplantation Rénale [CHU Brabois]
13 Hôpital Lariboisière-Fernand-Widal [APHP]

Abstract Background Whilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort. Methods In this study, cause-specific Cox models were used to study patient and graft survival and several other time-to-event measures. Logistic regressions were performed to study surgical complications at 30 days post-transplantation as well as delayed graft function. Results Among the 4691 included patients, 747 patients were considered obese with a BMI level greater than 30 kg/m 2 . We observed a higher mortality for obese recipients (HR = 1.37, p = 0.0086) and higher risks of serious bacterial infections (HR = 1.24, p = 0.0006) and cardiac complications (HR = 1.45, p < 0.0001). We observed a trend towards death censored graft survival (HR = 1.22, p = 0.0666) and no significant increased risk of early surgical complications. Conclusions We showed that obesity increased the risk of death and serious bacterial infections and cardiac complications in obese French kidney transplant recipients. Further epidemiologic studies aiming to compare obese recipients versus obese candidates remaining on dialysis are needed to improve the guidelines for obese patient transplant allocation.

Domaines: Santé publique et épidémiologie

Y. Foucher, Marine Lorent, L. Albano, S. Roux, V. Pernin, et al.. Renal transplantation outcomes in obese patients: a French cohort-based study. BMC Nephrology, 2021, 22 (1), ⟨10.1186/s12882-021-02278-1⟩. ⟨hal-03292105⟩