Long-term kidney transplant outcome in obese patients in a predominantly African American population.

The impact of obesity on long-term kidney transplant outcome has largely been studied in non-African American patients. This study seeks to determine differences in outcome between obese and non-obese patients after kidney transplantation, in a predominantly African American population. We reviewed 642 adult renal transplant recipients who received their transplants at SUNY Downstate Medical Center between 1998 and 2007. Sixty-six percent of the patients studied were African American. The patients were divided into five groups according to their BMI status: underweight < 20, normal 20-24.9, overweight 25-29.9, obese 30-34.9, and morbidly obese >= 35. There were no differences in race, gender, cytomegalovirus infection, type of transplant, panel-reactive antibody, retransplant status, flow cytometry cross-match results, mycophenolate mofetil therapy, and total HLA mismatch status. The mean discharge serum creatinine in the morbidly obese group was significantly higher than in other groups (p < 0.001). The difference in creatinine level disappeared at six wk and six months (p > 0.5), respectively. Acute rejection rates, delayed graft function, graft survival, and patient survival were not different between the groups. The findings from this large single-center study suggest that obese and morbidly obese patients had similar outcomes compared to other weight groups. Obese and morbidly obese African American patients should not be excluded from kidney transplantation on the basis of weight alone.