Open Renal Transplantation in Obese Patients: A Correlation Study between BMI and Early and Late Complications with Implementation of a Prognostic Risk Score.

kidney transplant obesity prognostic risk score

Journal

Life (Basel, Switzerland)
ISSN: 2075-1729
Titre abrégé: Life (Basel)
Pays: Switzerland
ID NLM: 101580444

Informations de publication

Date de publication:
22 Jul 2024
Historique:
received: 10 06 2024
revised: 18 07 2024
accepted: 19 07 2024
medline: 27 7 2024
pubmed: 27 7 2024
entrez: 27 7 2024
Statut: epublish

Résumé

Obesity is a global epidemic that affects millions worldwide and can be a deterrent to surgical procedures in the population waiting for kidney transplantation. However, the literature on the topic is controversial. This study evaluates the impact of body mass index (BMI) on complications after renal transplantation, and identifies factors associated with major complications to develop a prognostic risk score. A correlation analysis between BMI and early and late complications was first performed, followed by a univariate and multivariate logistic regression analysis. The 302 included patients were divided into obese (BMI ≥ 30 kg/m The model's area (AUC) was 0.6457 (95% IC: 0.57; 0.72). The percentage of cases correctly identified by this model retrospectively applied to the entire cohort was 73.61%. A high BMI seems to be associated with an increased risk of DGF, but it does not appear to be a risk factor for other complications. Using an easy-to-use model, identification, and stratification of individualized risk factors could help to identify the need for interventions and, thus, improve patient eligibility and transplant outcomes. This could also contribute to maintaining an approach with high ethical standards.

Sections du résumé

BACKGROUND BACKGROUND
Obesity is a global epidemic that affects millions worldwide and can be a deterrent to surgical procedures in the population waiting for kidney transplantation. However, the literature on the topic is controversial. This study evaluates the impact of body mass index (BMI) on complications after renal transplantation, and identifies factors associated with major complications to develop a prognostic risk score.
METHODS METHODS
A correlation analysis between BMI and early and late complications was first performed, followed by a univariate and multivariate logistic regression analysis. The 302 included patients were divided into obese (BMI ≥ 30 kg/m
RESULTS RESULTS
The model's area (AUC) was 0.6457 (95% IC: 0.57; 0.72). The percentage of cases correctly identified by this model retrospectively applied to the entire cohort was 73.61%.
CONCLUSIONS CONCLUSIONS
A high BMI seems to be associated with an increased risk of DGF, but it does not appear to be a risk factor for other complications. Using an easy-to-use model, identification, and stratification of individualized risk factors could help to identify the need for interventions and, thus, improve patient eligibility and transplant outcomes. This could also contribute to maintaining an approach with high ethical standards.

Identifiants

pubmed: 39063668
pii: life14070915
doi: 10.3390/life14070915
pii:
doi:

Types de publication

Journal Article

Langues

eng

Auteurs

Sara Marzorati (S)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Domenico Iovino (D)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Davide Inversini (D)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.
Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy.

Valentina Iori (V)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Cristiano Parise (C)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Federica Masci (F)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Linda Liepa (L)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Mauro Oltolina (M)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Elia Zani (E)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Caterina Franchi (C)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Marika Morabito (M)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.

Mattia Gritti (M)

Department of General Surgery, Humanitas Clinical and Research Center, 20089 Rozzano, Italy.

Caterina Di Bella (C)

Kidney and Pancreas Transplantation Unit, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, 35128 Padova, Italy.

Silvia Bisogno (S)

Department of Cardiologic Intensive Care, Hemodynamics and Cardiology, S.M. Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy.

Alberto Mangano (A)

Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL 60607, USA.

Matteo Tozzi (M)

Vascular Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.
Department of Medicine and Surgery (DMC), University of Insubria, 21100 Varese, Italy.

Giulio Carcano (G)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.
Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy.

Giuseppe Ietto (G)

General, Emergency and Transplant Surgery Department, ASST-Sette Laghi, 21100 Varese, Italy.
Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy.

Classifications MeSH