THEODORA YIU1, MICHAEL COLLINS2
1Counties Manukau and Auckland District Health Boards, Auckland, New Zealand, 2Central Northern Adelaide Renal and Transplantation Service , Adelaide, Australia
Aim
To review surgical complication rates and outcomes of obese versus non obese kidney transplants at a single transplant centre.
Background
Obesity is a significant health problem in New Zealand (NZ), with a high prevalence in patients with kidney failure. Whilst transplant is the best form of kidney replacement therapy, data on outcomes and complications in NZ obese recipients are lacking.
Methods
A retrospective clinical audit of adult kidney transplants at Auckland City Hospital in 2018 and 2019 was performed to evaluate the association of obesity (BMI ≥30) with surgical complications and other important outcomes. The primary outcome was a composite of wound dehiscence, infection or perinephric collection. Key secondary outcomes were poor wound healing (dehiscence, infection or use of negative pressure dressings), and graft function.
Results
223 transplant recipients were included in the analysis. Ninety (40.3%) recipients were obese (BMI ≥30). Thirty two (14.3%) had BMI ≥35. The primary outcome occurred in 20/90 (22%) obese and 19/133 (14%) non-obese recipients (p=0.12). Poor wound healing occurred more frequently in the obese group (23/90 (26%) vs 16/133 (12%); p=0.009). After adjustment for ethnicity, diabetes, smoking, hypertension and time on dialysis, this association was no longer significant (odds ratio [OR] 1.67, 95% CI 0.72-3.88, p=0.2). Delayed graft function was more common in the obese group (34% vs 18%, p = 0.02), though not after adjustment (OR 1.69, CI 0.79–3.62, p=0.2). One-year graft survival was similar in both groups (94% vs 95%).
Conclusion
Obesity was not significantly associated with surgical complications or poor wound healing in our centre after adjustment for confounders. Short -term graft outcomes were similar in obese vs non-obese recipients.
Biography:
Theodora is a renal advance trainee based in the Auckland Region. She is currently working at Middlemore Hospital in her third year of renal training.