CoChat
Sign Up
Cited by 222Renal Transplantation Outcomes and TreatmentsOrgan Donation and TransplantationTransplantation: Methods and Outcomes

The DOI matches its Crossref record; 103 of the 103 references it cites were found in a registry or an index.

Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis

Open access
Lafranca, Jeffrey A, IJermans, Jan NM, Betjes, Michiel GH, Dor, Frank JMF·2015·BMC Medicine
DOI 10.1186/s12916-015-0340-5PMC PMC4427990
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Whether overweight or obese end stage renal disease (ESRD) patients are suitable for renal transplantation (RT) is often debated. The objective of this review and meta-analysis was to systematically investigate the outcome of low versus high BMI recipients after RT. METHODS: Comprehensive searches were conducted in MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and CENTRAL (the Cochrane Library 2014, issue 8). We reviewed four major guidelines that are available regarding (potential) RT recipients. The methodology was in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and written based on the PRISMA statement. The quality assessment of studies was performed by using the GRADE tool. A meta-analysis was performed using Review Manager 5.3. Random-effects models were used. RESULTS: After identifying 5,526 studies addressing this topic, 56 studies were included. We extracted data for 37 outcome measures (including data of more than 209,000 RT recipients), of which 26 could be meta-analysed. The following outcome measures demonstrated significant differences in favour of low BMI (<30) recipients: mortality (RR = 1.52), delayed graft function (RR = 1.52), acute rejection (RR = 1.17), 1-, 2-, and 3-year graft survival (RR = 0.97, 0.95, and 0.97), 1-, 2-, and 3-year patient survival (RR = 0.99, 0.99, and 0.99), wound infection and dehiscence (RR = 3.13 and 4.85), NODAT (RR = 2.24), length of hospital stay (2.31 days), operation duration (0.77 hours), hypertension (RR = 1.35), and incisional hernia (RR = 2.72). However, patient survival expressed in hazard ratios was in significant favour of high BMI recipients. Differences in other outcome parameters were not significant. CONCLUSIONS: Several of the pooled outcome measurements show significant benefits for 'low' BMI (<30) recipients. Therefore, we postulate that ESRD patients with a BMI >30 preferably should lose weight prior to RT. If this cannot be achieved with common measures, in morbidly obese RT candidates, bariatric surgery could be considered.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12916-015-0340-5

Cites

103 of 103 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure 1 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart of the systematic literature search.
Figure 1 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart of the systematic literature search.CC BY · PubMed Central
Figure 2 Summary of findings table of extended criteria in live kidney donation generated by the GRADE tool.
Figure 2 Summary of findings table of extended criteria in live kidney donation generated by the GRADE tool.CC BY · PubMed Central
Figure 3 Forest plot of comparison: high versus low BMI recipients; outcome: mortality.
Figure 3 Forest plot of comparison: high versus low BMI recipients; outcome: mortality.CC BY · PubMed Central
Figure 4 Forest plot of comparison: high versus low BMI recipients; outcome: patient survival at 1, 2, and 3 years.
Figure 4 Forest plot of comparison: high versus low BMI recipients; outcome: patient survival at 1, 2, and 3 years.CC BY · PubMed Central
Figure 5 Forest plot of comparison: high versus low BMI recipients; outcome: graft survival at 1, 2, and 3 years and hazard ratio of graft survival.
Figure 5 Forest plot of comparison: high versus low BMI recipients; outcome: graft survival at 1, 2, and 3 years and hazard ratio of graft survival.CC BY · PubMed Central
Figure 6 Forest plot of comparison: high versus low BMI recipients; outcome: delayed graft function.
Figure 6 Forest plot of comparison: high versus low BMI recipients; outcome: delayed graft function.CC BY · PubMed Central
Figure 7 Forest plot of comparison: high versus low BMI recipients; outcome: acute rejection.
Figure 7 Forest plot of comparison: high versus low BMI recipients; outcome: acute rejection.CC BY · PubMed Central
Figure 8 Forest plot of comparison: high versus low BMI recipients; outcome: operation duration and length of stay.
Figure 8 Forest plot of comparison: high versus low BMI recipients; outcome: operation duration and length of stay.CC BY · PubMed Central
Figure 9 Forest plot of comparison: high versus low BMI recipients; outcome: wound infection and incisional hernia.
Figure 9 Forest plot of comparison: high versus low BMI recipients; outcome: wound infection and incisional hernia.CC BY · PubMed Central
Figure 10 Forest plot of comparison: high versus low BMI recipients; outcome: wound dehiscence and surgical adverse events.
Figure 10 Forest plot of comparison: high versus low BMI recipients; outcome: wound dehiscence and surgical adverse events.CC BY · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 12

  1. Turner C, Nogueira J. The effect of obesity on allograft outcomes in a single-center cohort of living renal transplant recipients. Am J Transplant. 2007;7:464.
  2. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011.
  3. Begov I, Akkina S, Benedetti E, Tang I. Obesity does not adversely affect the outcomes of kidney transplantation. Am J Transplant. 2013;13:261.
  4. Farooq U, Alshraideh Y, Orlando G, Rogers J, Farney A, Stratta R. Does high recipient BMI influence outcomes in deceased donor kidney transplantation? A paired donor kidney analysis. Am J Transplant. 2014;14:74.
  5. Gusukuma LW, Harada KM, Baptista APM, Alencar MRP, Freitas TVS, Tedesco-Silva H, et al. Clinical outcomes in obese kidney transplantation. Am J Transplant. 2011;11:364.
  6. Impedovo SV, Palazzo S, Bettocchi C, Grandaliano G, Schena FP, Gesualdo L, et al. Effect of obesity on long-term results of renal transplantation: a single center experience. Am J Transplant. 2012;12:249.
  7. Powers BD, Sifontis NM, Yung E, Spurrier D, Constantinescu S, Lee I, et al. 3 year outcomes of renal transplantation in high-risk obese recipients. Am J Transplant. 2010;10:64.
  8. Rajab A, Warrick J, Pelletier RP, Henry ML, Elkhammas EA, Bumgardner GL, et al. The effects of obesity on renal transplant recipients. Am J Transplant. 2007;7:464.
  9. Ravindra K, Irish W, Vikraman D, Castleberry A, Barbas A, Sanoff S, et al. Impact of recipient BMI: implications for ECD renal transplantation. Am J Transplant. 2013;13:195.
  10. Walczak DA, Campara M, Walczak D, McClure E, Oberholzer J, Akkina S, et al. Effect of obesity on the outcomes of ABO incompatible and positive crossmatch kidney transplants. Am J Transplant. 2010;10:437.
  11. Wolyniec Z, Debska-Slizien A, Rutkowski B. The influence of obesity on renal transplant outcomes - a paired kidneys analysis. Transpl ant Int. 2011;24:285.
  12. Molnar MZ, Kalantar-Zadeh K. Body composition and outcomes in dialysis patients and renal transplant recipients. Nephro Urol Mon. 2011;3:155–63.

Cited by

Sorted by citations

See all 222

Related

See all

Metadata

Authors
Lafranca, J. A., IJermans, J. N., Betjes, M. G., & Dor, F. J.
Affiliations
Erasmus MC (NL)
Corresponding author
Dor, Frank JMF
ORCID
Venue
BMC Medicine
Publisher
Springer Science and Business Media LLC
Published
2015-05-12
Volume
13
Issue
1
Pages
111-111
ISSN
1741-7015 (ISSN-L)
DOI
10.1186/s12916-015-0340-5
PMC
PMC4427990
OpenAlex
W4211251578
Cited by
222
References
103
Citations by year
2026: 20 · 2025: 15 · 2024: 15 · 2023: 26 · 2022: 31 · 2021: 34 · 2020: 14 · 2019: 22 · 2018: 13 · 2017: 18 · 2016: 9 · 2015: 2
FWCI
3.05
Type
journal article
Language
en
Update notices
erratum (2015-06-15)
Open access
Licence
Locations
  • BMC Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Keywords
body mass index, kidney transplantation, obesity, end-stage renal disease, transplant outcomes, graft survival, mortality, delayed graft function, acute rejection, wound infection, bariatric surgery, weight loss, morbid obesity
MeSH terms
Female, Humans, Obesity, Morbid, Body Mass Index, Kidney Transplantation, Treatment Outcome, Transplant Recipients

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review