High BMI Raises Wound Complication Risk in Transplant Patients

Kidney transplant recipients with a high body mass index (BMI) have a greater risk of wound complications, researchers concluded.

In a retrospective study of 508 adult kidney transplant recipients,Stephanie Zrim, MD, of Flinders University in Adelaide, Australia, and colleagues found that wound complications occurred in 3% of patients with a BMI (in kg/m2) of 18.5-24.9 (normal weight), 8% of patients with a BMI of 25-29.9 (overweight), and 13% of those with a BMI of 30 or higher (obese), according to findings published in Nephrology (2012;17:582-587).

In adjusted analyses, each 1-kg increase above 18.5/kg/m2 was associated with a 4% increased risk of wound complications, a 2% increased risk of delayed graft function at 24 hours, and a 6% increased risk of requiring an early nephrectomy, the investigators reported.

The authors concluded that their findings justify the use of elevated BMI as a contraindication to kidney transplantation, although their study identified no obvious threshold value of BMI that can be used to preclude patients from transplantation.

Higher BMI was not associated with surgical or urologic complications, or admission to intensive care units.

Of the 508 patients in the study, 122 were either obese (BMI of 30-34.9) or morbidly obese (BMI of 35 or higher).

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