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Raza Abidi SS, Naqvi A, Worthen G, Vinson A, Abidi S, Kiberd B, Skinner T, West K, Tennankore KK. Multiview Clustering to Identify Novel Kidney Donor Phenotypes for Assessing Graft Survival in Older Transplant Recipients. KIDNEY360 2023; 4:951-961. [PMID: 37291713 PMCID: PMC10371275 DOI: 10.34067/kid.0000000000000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023]
Abstract
Key Points An unsupervised machine learning clustering algorithm identified distinct deceased kidney donor phenotypes among older recipients. Recipients of certain donor phenotypes were at a relatively higher risk of all-cause graft loss even after accounting for recipient factors. The use of unsupervised clustering to support kidney allocation systems may be an important area for future study. Background Older transplant recipients are at a relatively increased risk of graft failure after transplantation, and some of this risk may relate to donor characteristics. Unsupervised clustering using machine learning may be a novel approach to identify donor phenotypes that may then be used to evaluate outcomes for older recipients. Using a cohort of older recipients, the purpose of this study was to (1 ) use unsupervised clustering to identify donor phenotypes and (2 ) determine the risk of death/graft failure for recipients of each donor phenotype. Methods We analyzed a nationally representative cohort of kidney transplant recipients aged 65 years or older captured using the Scientific Registry of Transplant Recipients between 2000 and 2017. Unsupervised clustering was used to generate phenotypes using donor characteristics inclusive of variables in the kidney donor risk index (KDRI). Cluster assignment was internally validated. Outcomes included all-cause graft failure (including mortality) and delayed graft function. Differences in the distribution of KDRI scores were also compared across the clusters. All-cause graft failure was compared for recipients of donor kidneys from each cluster using a multivariable Cox survival analysis. Results Overall, 23,558 donors were separated into five clusters. The area under the curve for internal validation of cluster assignment was 0.89. Recipients of donor kidneys from two clusters were found to be at high risk of all-cause graft failure relative to the lowest risk cluster (adjusted hazards ratio, 1.86; 95% confidence interval, 1.69 to 2.05 and 1.73; 95% confidence interval, 1.61 to 1.87). Only one of these high-risk clusters had high proportions of donors with established risk factors (i.e. , hypertension, diabetes). KDRI scores were similar for the highest and lowest risk clusters (1.40 [1.18–1.67] and 1.37 [1.15–1.65], respectively). Conclusions Unsupervised clustering can identify novel donor phenotypes comprising established donor characteristics that, in turn, may be associated with different risks of graft loss for older transplant recipients.
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Affiliation(s)
- Syed Sibte Raza Abidi
- Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Kanbay M, Copur S, Ucku D, Zoccali C. Donor obesity and weight gain after transplantation: two still overlooked threats to long-term graft survival. Clin Kidney J 2022; 16:254-261. [PMID: 36755848 PMCID: PMC9900567 DOI: 10.1093/ckj/sfac216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Indexed: 11/12/2022] Open
Abstract
The effect of donor obesity on kidney transplantation success has long been an overlooked clinical research area. Even though there is no strict guideline in most countries prohibiting donation from obese individuals, most candidates with a body mass index >35-40 kg/m2 are rejected due to concerns regarding long-term renal functional deterioration in the donor. The effects of excessive fat mass on renal function and allograft survival have been analysed by several longitudinal and follow-up studies. These studies have documented the deleterious effect on long-term graft outcomes of excessive body mass in living kidney donors and de novo obesity or pre-existing obesity worsening after transplantation on kidney outcomes. However, there is a paucity of clinical trials aimed at countering overweight and obesity in living and deceased kidney donors and in transplant patients. In this review we will briefly discuss the mechanism whereby fat excess induces adverse kidney outcomes and describe the effects on graft function and survival in living obese donors.
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Affiliation(s)
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Duygu Ucku
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Carmine Zoccali
- Renal Research Institute, New York, NY, USA,Department of Medicine, Division of Nephrology, Associazione Ipertensione, Nefrologia e Trapianto Renale, Nefrologia, Ospedali Riuniti, Reggio Calabria, Italy
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3
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Sharif A. Deceased Donor Characteristics and Kidney Transplant Outcomes. Transpl Int 2022; 35:10482. [PMID: 36090778 PMCID: PMC9452640 DOI: 10.3389/ti.2022.10482] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/25/2022] [Indexed: 11/25/2022]
Abstract
Kidney transplantation is the therapy of choice for people living with kidney failure who are suitable for surgery. However, the disparity between supply versus demand for organs means many either die or are removed from the waiting-list before receiving a kidney allograft. Reducing unnecessary discard of deceased donor kidneys is important to maximize utilization of a scarce and valuable resource but requires nuanced decision-making. Accepting kidneys from deceased donors with heterogenous characteristics for waitlisted kidney transplant candidates, often in the context of time-pressured decision-making, requires an understanding of the association between donor characteristics and kidney transplant outcomes. Deceased donor clinical factors can impact patient and/or kidney allograft survival but risk-versus-benefit deliberation must be balanced against the morbidity and mortality associated with remaining on the waiting-list. In this article, the association between deceased kidney donor characteristics and post kidney transplant outcomes for the recipient are reviewed. While translating this evidence to individual kidney transplant candidates is a challenge, emerging strategies to improve this process will be discussed. Fundamentally, tools and guidelines to inform decision-making when considering deceased donor kidney offers will be valuable to both professionals and patients.
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Affiliation(s)
- Adnan Sharif
- Department of Nephrology and Transplantation, University Hospitals Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Adnan Sharif,
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Breyer I, Dodin B, Djamali A, Jorgenson MR, Garg N, Aziz F, Mohamed MA, Mandelbrot DA, Parajuli S. Risk factors and outcomes of BK viremia among deceased donor kidney transplant recipients based on donor characteristics. Transpl Infect Dis 2021; 24:e13768. [PMID: 34825437 DOI: 10.1111/tid.13768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/22/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION BK polyomavirus (BKV) is a common infection among kidney transplant recipients (KTR). Risk factors and outcomes based on donor characteristics remain largely unknown. METHODS In this study, we aimed to analyze the impact of donor factors through a paired kidney analysis. We included 289 pairs of adult deceased donor transplants (578 KTRs total); each pair had received kidneys from the same donor. Recipient pairs were divided into three groups: "no BK group" if neither KTR developed BK viremia (n = 336), "discordant" if the only one did (n = 176), and "concordant" if both did (n = 66). Acute rejection (AR), graft failure, and BK nephropathy (BKN) were outcomes of interest. RESULTS Donors in the concordant group were younger, had lower kidney donor profile index (KDPI), and were less likely to be donor after circulatory death (DCD). In multivariate analyses, KTRs who had a donor with a higher body mass index (BMI) (hazard ratio (HR): 0.97; 95% confidence interval (CI): 0.95-0.99; p = .009) were less likely to develop BKV. Concordance was not associated with AR (HR: 0.83; 95% CI: 0.51-1.34; p = .45), graft failure (HR: 1.77; 95% CI: 0.42-7.50; p = .43), or BKN (HR: 1.02; 95% CI: 0.51-2.03; p = .96). DISCUSSION Our study suggests lower donor BMI is associated with BKV infection, and concordance or discordance between paired kidney recipients is not associated with poor outcomes.
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Affiliation(s)
- Isabel Breyer
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ban Dodin
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Arjang Djamali
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Margaret R Jorgenson
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Neetika Garg
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Fahad Aziz
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Maha A Mohamed
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Didier A Mandelbrot
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Sandesh Parajuli
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Lee SD, Rawashdeh B, McCracken EKE, Cantrell LA, Kharwat B, Demirag A, Agarwal A, Brayman KL, Pelletier SJ, Goldaracena N, Fox E, Oberholzer J. Robot-assisted kidney transplantation is a safe alternative approach for morbidly obese patients with end-stage renal disease. Int J Med Robot 2021; 17:e2293. [PMID: 34080270 DOI: 10.1002/rcs.2293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Many centres deny obese patients with a body mass index (BMI) >35 access to kidney transplantation due to increased intraoperative and postoperative complications. METHODS From August 2017 to December 2019, 73 consecutive cases of kidney transplantation in morbidly obese patients were enrolled at a single university at the initiation of a robotic transplant surgery program. Outcomes of patients who underwent robotic assisted kidney transplant (RAKT) were compared to frequency-matched patients undergoing open kidney transplant (OKT). RESULTS A total of 24 morbidly obese patients successfully underwent RAKT, and 49 obese patients received an OKT. The RAKT group developed fewer surgical site infections (SSI) than the OKT group. Graft function, creatinine, and glomerular filtration rate (GFR) were similar between groups 1 year after surgery. Graft and patient survival were 100% for both groups. CONCLUSIONS RAKT offers a safe alternative for morbidly obese patients, who may otherwise be denied access to OKT.
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Affiliation(s)
- Seung Duk Lee
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Badi Rawashdeh
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Emily K E McCracken
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Leigh A Cantrell
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia, USA
| | - Bassel Kharwat
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Alp Demirag
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Avinash Agarwal
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Kenneth L Brayman
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Shawn J Pelletier
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Nicolas Goldaracena
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Emily Fox
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - José Oberholzer
- Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
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Arshad A, Hodson J, Chappelow I, Nath J, Sharif A. Kidney transplantation outcomes for adult recipients of pediatric donor kidneys. Pediatr Transplant 2021; 25:e13767. [PMID: 32536011 DOI: 10.1111/petr.13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/23/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022]
Abstract
Despite a paucity of data assessing transplantation of deceased-donor pediatric donor kidneys into adult recipients, utilization of pediatric organs is declining in the UK, likely due to concerns that such organs may have inferior outcomes. However, we hypothesized that these concerns may be unfounded. As such, the aim of the study was to compare kidney transplant outcomes between adult recipients of pediatric and adult deceased-donor organs. Data were collected from the UK Transplant Registry for all adult (18+ years) deceased-donor single-kidney transplant recipients between January 2000 and January 2016. Univariable and multivariable analyses were undertaken, to compare a range of outcomes between recipients of kidneys from pediatric and adult donors. Transplants were stratified by the donor age (years) as follows: 0-16 (n = 666), 17-18 (n = 465), and 19-44 (n = 7378). Recipients of pediatric donor kidneys were observed to have improved long-term graft function, with a median creatinine at 1 year of 109 vs. 117 μmol/L for recipients of donors aged 0-16 vs. 19-44 years (P < .001). However, on multivariable analysis, this was not found to correspond to a significant difference in patient (P = .914) or graft survival (P = .190) between the donor age groups. Subgroup analysis within the younger donors found no significant differences in recipient outcomes between donors aged 0-6, 7-12, and 13-16 years. In this population cohort study, we identified excellent outcomes among adult recipients of pediatric donor kidneys. Pediatric donors are a valuable source of organs for adult recipients in an era where organ demand is rising.
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Affiliation(s)
- Adam Arshad
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - James Hodson
- Institute of Translational Medicine, Queen Elizabeth Hospital, Birmingham, UK
| | - Imogen Chappelow
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Jay Nath
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Department of Nephrology and Transplantation, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Adnan Sharif
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital Birmingham, Birmingham, UK.,Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
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Donor-recipient Sex Differences Do Not Affect Survival Outcomes After Kidney Transplantation: A Population Cohort Study. Transplantation 2020; 104:1033-1040. [PMID: 31415037 DOI: 10.1097/tp.0000000000002915] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Donor factors can influence decision making for organ utilization for potential kidney transplant candidates. Prior studies exploring the effect of donor-recipient sex matching on kidney transplant outcomes have reported heterogenous and conflicting results. The aim of this contemporary population-cohort analysis was to explore the effect of donor-recipient sex matching on kidney transplant outcomes in the United Kingdom. METHODS In this retrospective, observational study, we analyzed all patients receiving kidney-alone transplants between 2003 and 2018 using UK Transplant Registry data. Stratified by recipient sex, outcomes were compared between male and female donors with univariable/multivariable analyses. RESULTS Data were analyzed for 25 140 recipients. Of these, 13 414 (53.4%) of kidneys were from male donors and 15 690 (62.4%) of recipients were male. The odds of initial graft dysfunction (delayed graft function/primary nonfunction) were significantly lower for female donor kidneys transplanted into both male (adjusted odds ratio = 0.89, 95% confidence interval [CI] = 0.80-0.98, P = 0.019) and female (adjusted odds ratio = 0.81, 95% CI = 0.71-0.93, P = 0.003) recipients. Male recipients of female donor kidneys had creatinine levels at 1 year that were 6.3% higher (95% CI = 4.8%-7.7%, P < 0.001) than male recipients of male donor kidneys, with a similar sex difference of 4.1% (95% CI = 2.1%-6.1%, P < 0.001) observed within female recipients. However, neither patient nor graft survival was found to differ significantly by donor sex on either univariable or multivariable analysis. CONCLUSIONS Our data provide contemporary data on sex mismatch for recipient counseling and reassurance with regards to equivalent long-term clinical outcomes based upon donor sex.
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8
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Arshad A, Hodson J, Khalil K, Sharif A. Changes in Body Mass Index and Outcomes After Kidney Transplant: A Single-Center, Retrospective, Observational Study. EXP CLIN TRANSPLANT 2020; 18:292-299. [PMID: 32370695 DOI: 10.6002/ect.2019.0416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES We aimed to describe changes in body mass index after kidney transplant and to assess how these changes influence long-term outcomes. MATERIALS AND METHODS Data were collected from kidney transplant recipients seen at our center between January 2007 and July 2016. Changes in body mass index over the posttransplant period were modeled using a generalized estimating equation, with changes calculated for each patient from pretransplant to 6 months posttransplant. Calculations were then categorized into 3 body mass index groups: stable (change of ± 1.5 kg/m² or less), reduced (reduction of > 1.5 kg/m²), and increased (increase of > 1.5 kg/m²). Outcomes among groups were compared. RESULTS Among 1344 total patients, the geometric mean pretransplant body mass index was 27.3 kg/m². This declined significantly (P < .001) to a geometric mean of 25.6 kg/m² at 1 month posttransplant, before increasing and stabilizing to pretransplant levels by 36 months (geometric mean body mass index of 27.2 kg/m² ; P = .522). Of 822 patients with body mass index measurements at 6 months, 303 had reduced, 388 had stable, and 131 had increased levels relative to pretransplant levels. On multivariate analyses, 12-month creatinine levels were significantly higher in the reduced cohort, with adjusted levels of 160.6 versus 135.0 μmol/L for the stable cohort. However, no significant associations were detected between 6-month body mass index changes and patient survival, graft survival, incidences of posttransplant diabetes and cancer, and a range of other clinical and histologic outcomes (all P > .05). CONCLUSIONS Our data demonstrated that body mass index was significantly reduced in the first month after kidney transplant before increasing to pretransplant levels during years 3 to 5. Furthermore, patients who retained decreased levels at 6 months had impaired graft function in long-term follow-up. These observations conflict with the existing literature and warrant further investigations.
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Affiliation(s)
- Adam Arshad
- From the College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Giffen ZC, Siddique AB, Koizumi N, Ortiz J. Small donor size does not negatively impact outcomes after deceased-donor renal transplantation. Clin Transplant 2020; 34:e13886. [PMID: 32335953 DOI: 10.1111/ctr.13886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/28/2022]
Abstract
Higher body mass index (BMI) of deceased-donors is associated with poorer outcomes in transplant recipients. The effect of low donor BMI on recipient graft function is not clear. Scientific Registry of Transplant Recipients data on recipients of deceased-donor kidneys from 2000 to 2019 were categorized by donor BMI (donor BMI < 18, 18-27, and >27). Primary outcome was death-censored graft survival. The impact of multiple recipient and donor variables, including low donor BMI and the difference between donor and recipient BMI, was evaluated using a multivariate Cox proportional-hazards model. Low BMI donors (LBD) were more likely to be younger, female, and white (all P < .05). LBD were less likely to be Hispanic, diabetic, or have hypertension (all P < .001). LBD recipients were more likely to be younger and female (both P < .001). Low donor BMI was not significantly associated with recipient graft survival. Donor-recipient BMI difference did not correlate with an increased risk of graft failure. Similar results were obtained when donors were classified using body surface area (BSA). Small donor size in terms of BMI or BSA or a large discrepancy between donor and recipient size should not necessarily preclude transplantation of an otherwise acceptable kidney.
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Affiliation(s)
- Zane C Giffen
- Department of Urology, University of Toledo, Toledo, OH, USA
| | - Abu Bakkar Siddique
- Schar School of Policy and Government, George Mason University, Arlington, VA, USA
| | - Naoru Koizumi
- Schar School of Policy and Government, George Mason University, Arlington, VA, USA
| | - Jorge Ortiz
- Department of Surgery, University of Toledo, Toledo, OH, USA
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10
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Naik AS, Zhong Y, Parasuraman R, Doshi M, Norman S, Lu Y, Shaban E, Shahinian V, Schaubel DE. The temporal and long-term impact of donor body mass index on recipient outcomes after kidney transplantation - a retrospective study. Transpl Int 2019; 33:59-67. [PMID: 31478267 DOI: 10.1111/tri.13505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/19/2018] [Accepted: 08/25/2019] [Indexed: 11/30/2022]
Abstract
The impact of increasing body mass index (BMI) on development and progression of chronic kidney disease is established. Even implantation kidney biopsies from obese living donors demonstrate subtle histologic changes despite normal function. We hypothesized that kidneys from obese living (LD) and deceased donors (DD) would have inferior long-term allograft outcomes. In a study utilizing US transplant registry, we studied adult kidney transplant recipients from 2000 to 2014. Donors were categorized as BMI <20 (underweight), 20-25 (normal), 25-30 (overweight), 30-35 (mildly obese), and >35 kg/m2 (very obese). Our outcome of interest was death censored graft failure (DCGF). Cox proportional hazards model were fitted separately for recipients of DD and LD kidneys, and adjusted for donor, recipient, and transplant characteristics, including donor and recipient size mismatch ratio. Among 118 734 DD and 84 377 LD transplants recipients, we observed a significant and graded increase in DCGF risk among the overweight (LD:HR = 1.06, DD:HR = 1.04), mildly obese (LD:HR = 1.16, DD:HR = 1.10), and very obese (LD:HR = 1.22, DD:HR = 1.22) compared to normal BMI (P < 0.05). The graded effect of donor BMI on outcomes begins early and persists throughout the post-transplant period. Donor obesity status is an independent risk factor for inferior long-term renal allograft outcome despite adjusting for donor and recipient size mismatch and other donor, recipient, and transplant factors.
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Affiliation(s)
- Abhijit S Naik
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Yingchao Zhong
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Ravi Parasuraman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Mona Doshi
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Silas Norman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Yee Lu
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Eman Shaban
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Vahakn Shahinian
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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11
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Sharif A. Should donor body mass index influence kidney utilization by transplant centers? Transpl Int 2019; 33:56-58. [PMID: 31554013 DOI: 10.1111/tri.13529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Adnan Sharif
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
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12
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Lim WH, Wong G. Organ donors - does size really matter? Transpl Int 2018; 31:1086-1088. [DOI: 10.1111/tri.13283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 05/22/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Wai H. Lim
- Department of Renal Medicine; Sir Charles Gairdner Hospital; Perth WA Australia
- School of Medicine; University of Western Australia; Perth WA Australia
| | - Germaine Wong
- Centre for Kidney Research; Children's Hospital at Westmead; Sydney NSW Australia
- School of Public Health; Sydney Medical School; The University of Sydney; Sydney NSW Australia
- Department of Renal Medicine and Transplantation Service; Westmead Hospital; Sydney NSW Australia
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