Surgical and Clinical Outcomes of Kidney Transplantation in Obese Recipients: A Single-Center Retrospective Study from Switzerland.

BACKGROUND

The impact of recipient obesity on kidney transplant outcomes remains controversial. This study aimed to assess the effect of recipient obesity on short- and long-term outcomes following kidney transplantation (KT).

METHODS

This single-center retrospective cohort study included all consecutive adult patients who underwent KT between January 1999 and December 2023 at the Transplantation Center of Lausanne University Hospital (CHUV), Lausanne, Switzerland. Surgical complications, delayed graft function (DGF), and graft survival were compared between obese (BMI ≥ 30 kg/m2) and non-obese recipients (BMI < 30 kg/m2).

RESULTS

A total of 953 patients were included, of whom 150 (16%) were obese. Obesity was associated with higher rates of surgical site infections (11% vs. 3%, p < 0.001), overall infections (29% vs. 5%, p < 0.001), lymphoceles (18% vs. 10%, p = 0.007), and incisional hernias (10% vs. 5%, p = 0.032). Length of hospital stay (19 vs. 17 days, p = 0.038) and DGF rates (21% vs. 14%, p = 0.024) were also higher in obese recipients. Patient survival (HR 1.09, 95% CI 0.59-1.99; p = 0.766) and death-censored graft survival (HR 0.92, 95% CI 0.29-2.92; p = 0.886) were comparable between groups at a median follow-up of 7.3 years (IQR, 3.3-12.4).

CONCLUSIONS

Recipient obesity was associated with an increased risk of surgical complications and DGF, resulting in longer hospital stays. However, it did not adversely affect long-term patient or graft survival. Therefore, despite higher early complications, obesity should not be considered a contraindication to KT.