Morbidly obese kidney transplant recipients are at increased risk of post-transplant opportunistic viral infections, especially those caused by cytomegalovirus (CMV), researchers reported at the 2016 American Transplant Congress in Boston.
Sara Strout, PharmD, and collaborators at the Medical University of South Carolina in Charleston studied 308 kidney transplant recipients, of whom 103 had a body mass index of 35 kg/m2 or higher (morbidly obese) and 205 patients had a BMI less than 35 kg/m2. The patients were propensity score matched according to age, race, deceased donor transplant and other characteristics. The median duration of post-transplant follow-up was 2.8 years.
The morbidly obese and non-morbidly obese groups showed no significant difference in the overall rate of infections: 51.2% and 55.3%, respectively. The morbidly obese group experienced more opportunistic viral infections overall than the non-morbidly obese group (52.4% vs. 37.1%), as well as more cytomegalovirus (CMV) infections (27.2% vs. 16.1%). The rates of CMV syndrome or disease did not differ significantly between the groups.
The rates of BK virus and Epstein-Barr virus infections were similar between the groups.
The morbidly obese patients also experienced similar rates of significant non-opportunistic infections, defined as any non-opportunistic infection requiring or prolonging hospitalization for treatment.
With regard to study limitations, Dr. Strout’s team pointed to the small sample size and limited number of patient events, which may have limited the ability to detect a difference in some outcomes. The researchers also noted that they did not assess adherence to anti-infective prophylaxis.