Transplant surgery and the obese patient: special considerations

Perhaps as a consequence of increased obesity in the general population, the likelihood of obese patients receiving kidney transplants has more than doubled. Obesity confers increased risk for graft loss and death among renal transplant recipients. However, the relationship of changes in body weight and composition to outcome on the transplant waitlist and posttransplantation are not straightforward. Strategies to manage weight in the waitlisted and post-kidney transplantation patient must be performed in the context of a multidisciplinary approach and individualized to risk factors in particular patients. While retrospective studies offer considerable insight into the relationship between obesity and kidney transplant outcome, causal inferences must be made with great caution.