INFLUENCE OF OBESITY ON RESULTS OF KIDNEY -TRANSPLANTATION

Background and Aim: Obesity is a risk factor for postoperative complic ations in surgery. In a retrospective study we investigated the course of body weight during the waiting period and the first postoperative year and the influence obesity on graft function. Patients and Method: The medical records of 334 adult patients undergoing cadaveric kidney transplantation between 1986 and 1992 were reviewed. Immunosuppressio n was performed with cyclosporine and prednisone. For all patients the Broca index was calculated with the relative body weight by the formu la: body weight/ Broca index x 100 (% BI). Obesity was defined as rela tive body weight greater than or equal to 120% BI. Results: At the tim e of the indication for kidney transplantation 15.3% of the patients w ere obese. Only 12 of these 51 obese patients reduced their body weigh t below 120% BI until transplantation, whereas 25 patients increased w eight in excess of 120% BI. Thus the number of obese patients raised t o 19.2% by the time of transplantation. The graft survival in the obes e group was significantly lower than in the nonobese group. This diffe rence appeared already in the First half-year after transplantation be ing constant in the following time. The resulting 1-year graft surviva l was 82.8% and 91.4% respectively (p < 0.05). During the first year 5 9 patients more became obese, the percentage of obese raised up to 36. 0%. One year after transplantation there was no longer significant dif ference of graft survival rate in the further follow-up between obese and nonobese patients. Conclusion: Our findings show, that obesity is an important risk factor for early graft loss. Therefore all participa ting physicians assume a great responsibility for the pre-operative tr eatment during the waiting time.