Most obese patients with kidney failure experience a survival benefit from a kidney transplant, but this benefit is smaller in extremely obese patients, defined as those with a body mass index (BMI) of 40 kg/m2 or higher.

At one-year post-transplant, the risk of death was reduced by 66% or more in transplant recipient with a BMI below 40, but was reduced by only 48% in recipients with a BMI of 40 or higher, according to findings published in the American Journal of Transplantation (2013;13:2083-2090). 

The study, by John S. Gill, MD, MS, of the University of British Columbia in Vancouver, and colleagues also found an uncertain survival benefit in black patients with a BMI of 40 or higher. Living donor transplantation was associated with a reduced death risk of 66% or more in all BMI groups.

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