The Impact of Obesity and Associated Comorbidities on the Outcomes after Renal Transplantation with a Living Donor vs. Deceased Donor Grafts
Abstract
:1. Introduction
2. Methods
2.1. Patient Selection
2.2. Perioperative Management
2.3. Clinical Outcomes
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Study Group Obese–Morbidly Obese | Control Group Normal Weight–Overweight | p Value | |
---|---|---|---|
Recipients, number | 314 (22.4%) | 1089 (77.6%) | |
Age, (year) [mean ± SD] | 55.40 ± 11.94 | 48.43 ± 15.53 | p < 0.001 |
Gender, number | p = 0.158 | ||
Male | 224 (71.3%) | 731 (67.1%) | |
Female | 90 (28.7%) | 358 (32.9%) | |
BMI (kg/m2) ± SD | 33.25 ± 2.83 | 24.30 ± 3.18 | p < 0.001 |
Weight (kg) ± SD | 94.92 ± 12.37 | 69.97 ± 13.25 | p < 0.001 |
Comorbidity, number | |||
T2DM | 147 (46.8%) | 235 (21.6%) | p < 0.001 |
IHD | 100 (33%) | 194 (18.5%) | p < 0.001 |
Kidney disease, number | p < 0.001 | ||
T2DM | 101 (32.2%) | 158 (14.5%) | |
HTN | 35 (11.1%) | 56 (5.1%) | |
PKD | 30 (9.6%) | 153 (14.0%) | |
FSGS | 29 (9.2%) | 86 (7.9%) | |
GN | 21 (6.7%) | 99 (9.1%) | |
Pyelonephritis | 5 (1.6%) | 63 (5.8%) | |
Other | 29 (9.2%) | 143 (13.1%) | |
Congenital | 4 (1.3%) | 76 (7.0%) | |
Unknown | 45 (14.3%) | 178 (16.3%) | |
Preemptive transplant | 49(17.7%) | 265 (23.5%) | p = 0.037 |
Re-transplant, number | 27 (8.6%) | 188 (17.3%) | p < 0.001 |
Donor age, mean ± SD | 47.67 ± 14.61 | 45.71 ± 13.95 | p = 0.005 |
Donor type, number | p = 0.008 | ||
Deceased | 137 (43.6%) | 384 (35.2%) | |
Living | 177 (56.4%) | 705 (64.7%) | |
Time on dialysis (months, mean ± SD) | 33.7 ± 39.6 | 37.0 ± 33.6 | p = 0.180 |
Time on dialysis, LD | 16.5 ± 24.2 | 19.6 ±24.0 | p = 0.252 |
Time on dialysis, DD | 60. 1 ± 29.9 | 65.2 ± 38.4 | p = 0.158 |
PRA class I (+), number (%) | 15 (5.5%) | 75 (7.6%) | p = 0.103 |
PRA class II (+), number (%) | 11(4%) | 67 (6.8%) | p = 0.103 |
HLA-A 0 match, number (%) | 142 (50.2%) | 508 (49.4%) | p = 0.125 |
HLA-B 0 match, number (%) | 164 (56.9%) | 582 (56.5%) | p = 0.016 |
HLA-DR 0 match, number (%) | 121 (45.7%) | 409 (43.7%) | p = 0.575 |
6 HLA mismatch, number (%) | 54 (17.2%) | 212 (19.5%) | p = 0.901 |
Study Group Obese-Morbidly Obese | Control Group Normal Weight- Overweight | p Value | |
---|---|---|---|
Recipients, number | 314 (22.4%) | 1089 (77.6%) | |
LOS (days), mean ± SD | 14.28 ± 25.27 | 10.89 ± 12.849 | p = 0.002 |
DGF number | 95 (30.7%) | 182 (17.0%) | p < 0.001 |
PNF, number | 7 (2.3%) | 8 (0.7%) | p < 0.001 |
Rejection, number | p = 0.197 | ||
Cellular | 25 (8.0%) | 64 (5.9%) | p = 0.228 |
Humoral | 10 (3.2%) | 19 (1.7%) | p = 0.175 |
Status of graft loss * | 69 (22.3%) | 148 (13.5%) | p < 0.001 |
Status death * | 36 (11.7%) | 84 (7.7%) | p = 0.027 |
Creatinine (mg/dL) (total number of patients), mean ± SD | |||
30 days (n = 1318) | 1.78 ± 1.16 | 1.52 ±0.99 | p < 0.001 |
180 days (n = 1197) | 1.52 ± 0.89 | 1.41 ± 0.68 | p = 0.031 |
1 year (n = 1099) | 1.48 ± 0.80 | 1.38 ± 0.78 | p = 0.097 |
3 years (n = 656) | 1.79 ± 1.92 | 1.52 ± 1.40 | p = 0.060 |
HR [Exp(B)] | 95.0% CI for Exp(B) Lower | 95.0% CI for Exp(B) Upper | p Value | |
---|---|---|---|---|
Cox regression for graft loss | ||||
IHD (Y/N) | 1.892 | 1.496 | 2.687 | p < 0.001 |
BMI (kg/m2) | 1.038 | 1.010 | 1.066 | p = 0.007 |
Donor Age (year) | 1.018 | 1.008 | 1.028 | p < 0.001 |
1st/reTx (Y/N) | 1.750 | 1.177 | 2.602 | p = 0.006 |
LD/DD | 2.491 | 1.857 | 3.340 | p < 0.001 |
Cox regression for mortality | ||||
Age (year) | 1.054 | 1.033 | 1.074 | p < 0.001 |
DM (Y/N) | 2.089 | 1.414 | 3.088 | p < 0.001 |
IHD (Y/N) | 1.761 | 1.192 | 2.600 | p = 0.004 |
LD/DD | 2.682 | 1.801 | 3.992 | p < 0.001 |
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Yemini, R.; Rahamimov, R.; Nesher, E.; Anteby, R.; Ghinea, R.; Hod, T.; Mor, E. The Impact of Obesity and Associated Comorbidities on the Outcomes after Renal Transplantation with a Living Donor vs. Deceased Donor Grafts. J. Clin. Med. 2022, 11, 3069. https://doi.org/10.3390/jcm11113069
Yemini R, Rahamimov R, Nesher E, Anteby R, Ghinea R, Hod T, Mor E. The Impact of Obesity and Associated Comorbidities on the Outcomes after Renal Transplantation with a Living Donor vs. Deceased Donor Grafts. Journal of Clinical Medicine. 2022; 11(11):3069. https://doi.org/10.3390/jcm11113069
Chicago/Turabian StyleYemini, Renana, Ruth Rahamimov, Eviatar Nesher, Roi Anteby, Ronen Ghinea, Tammy Hod, and Eytan Mor. 2022. "The Impact of Obesity and Associated Comorbidities on the Outcomes after Renal Transplantation with a Living Donor vs. Deceased Donor Grafts" Journal of Clinical Medicine 11, no. 11: 3069. https://doi.org/10.3390/jcm11113069
APA StyleYemini, R., Rahamimov, R., Nesher, E., Anteby, R., Ghinea, R., Hod, T., & Mor, E. (2022). The Impact of Obesity and Associated Comorbidities on the Outcomes after Renal Transplantation with a Living Donor vs. Deceased Donor Grafts. Journal of Clinical Medicine, 11(11), 3069. https://doi.org/10.3390/jcm11113069