Navigation Links
Extreme obesity affects chances of kidney transplantation
Date:1/10/2008

For patients on the waiting list for a kidney transplant, severe and morbid obesity are associated with a lower chance of receiving an organ, reports a study in the February Journal of the American Society of Nephrology.

Led by Dr. Dorry L. Segev of the Johns Hopkins University School of Medicine, the researchers used data from the United Network for Organ Sharing (UNOS) to examine how obesity affects waiting times for kidney transplantation. "The results identify a potential bias in organ allocation that is not consistent with the goals of our allocation system," Dr. Segev comments. "Obese patients are waiting longer for kidney transplants when compared with their non-obese counterparts, even after adjusting for all medical factors tracked through UNOS."

Dr. Segev and colleagues analyzed data on more than 132,000 patients wait-listed for kidney transplants from 1995 to 2004. As obesity increased, the likelihood of receiving a transplant decreased.

Adjusted for other factors, the chances of receiving a kidney transplant were 27 percent lower for patients classified as severely obese and 44 percent lower for morbidly obese patients, compared to normal-weight patients. (The chances of receiving a transplant were not significantly reduced for patients classified as overweight or mildly obese.)

In addition, when a kidney became available, patients in the highest categories of obesity were more likely to be "bypassed"that is, their physician was more likely to decline the offer of a kidney. The chances of being bypassed were 11 percent higher for severely obese patients and 22 percent higher for morbidly obese patients.

The findings raise concerns that obesity may be a previously unappreciated source of bias in organ allocation. "It is possible that providers are bypassing obese patients and instead transplanting non-obese patients because they feel that kidneys are a scarce resource and they want the kidneys to go to the patients who will benefit most from them," says Dr. Segev. "However, there is strong evidence that even obese patients will benefit significantly from a kidney transplant. And more importantly, the U.S. organ allocation system is not based on such medical decisions, but instead is based on the notion that everyone who gets listed deserves a fair chance at getting transplanted."

The bias might play out in other ways as well. Obese patients tend to have worse outcomes, which may reflect badly on the results achieved by doctors or hospitalspossibly even affecting quality measurements, which are increasingly tied to reimbursement. In addition, the reimbursement for transplant surgery is the same for difficult or complicated cases as for simpler cases. "These two practices generate a strong disincentive against challenging cases, and could potentially contribute to the bias against obese patients that we saw in our study," says Dr. Segev.

Dr. Segev notes that matching an available organ with an appropriate recipient requires clinical judgment, which could not be fully captured in this study. "However," he adds, "it is unlikely that these factors could explain such dramatic observations."


'/>"/>

Contact: Shari Leventhal
sleventhal@asn-online.org
202-416-0658
American Society of Nephrology
Source:Eurekalert

Related medicine news :

1. Extreme Networks Provides Resilient Wired and Wireless Network to the UKs Basildon & Thurrock Hospital
2. 3-drug combination extremely promising as first-line therapy for multiple myeloma
3. Which intervention would do the most to improve the health of the extreme poor?
4. A History of Philanthropy Made Green-certified Legend Homes an Easy Choice for Extreme Makeover: Home Edition
5. Elliott Extremely Dissatisfied With Genzyme Bid for Bioenvision; Believes Offer Significantly Undervalues Company
6. Eating out can have both positive and negative impact on obesity
7. Pipeline for New Obesity Therapies is Focus of New Report
8. Obesity linked to decreased seatbelt use
9. Discovery Healths Fifth Annual National Body Challenge Takes a Stand Against Obesity by Offering the Keys to Adopting a Healthy, Active Lifestyle
10. 2008 Presidential Hopefuls Fail to Respond to Questions About Obesity in U.S.
11. Cyberonics Licenses Obesity-Related Patents
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/22/2017)... ... August 22, 2017 , ... TopConsumerReviews.com recently gave a best-in-class 5-star rating ... , As the stress of modern life continually makes more demands on time and ... artificial stimulants can trap people in vicious high/low cycles and can also cause long ...
(Date:8/22/2017)... ... August 22, 2017 , ... Although Labor Day is not as popular ... begun providing weekend displays, and numerous households celebrate the unofficial end of summer with ... terrifying for pets. , Kris Zambo, owner of Dynamite Fireworks in ...
(Date:8/21/2017)... ... August 22, 2017 , ... ... risk to health and safety. By learning and implementing best practices for containment ... In this webinar, attendees will gain a better understanding of a method for ...
(Date:8/21/2017)... ... August 21, 2017 , ... ... of two plastic surgery fellows for academic year 2017-2018, Christina M. Busuito, M.D. ... have successfully completed residency in Plastic and Reconstructive Surgery. The candidate will ...
(Date:8/21/2017)... MINNEAPOLIS, MINN (PRWEB) , ... August 21, 2017 ... ... Sports Group, today announced that it has become the Official Technology Partner of ... their AES (Advanced Event Systems) volleyball software, along with providing sport ...
Breaking Medicine News(10 mins):
(Date:8/7/2017)... 2017 Zimmer Biomet Holdings, Inc. (NYSE and SIX: ... its Board of Directors has approved the payment of a ... 2017. The cash dividend ... October 27, 2017 to stockholders of record as of the ... dividends are subject to approval of the Board of Directors ...
(Date:8/7/2017)... 2017  Diplomat Pharmacy, Inc. (NYSE: DPLO), the nation,s largest ... June 30, 2017.  All comparisons, unless otherwise noted, are to ... Second Quarter 2017 Highlights include: ... an increase of 3.5% Total prescriptions dispensed ... of 7.5% versus 7.6% Gross profit ...
(Date:8/4/2017)... ROCKVILLE, Md. , Aug. 4, 2017 ... during or shortly after a physician/patient consult has long ... industry, and was a notable focus of the largest ...  This is according to healthcare market research firm Kalorama ... of care testing (POCT) offerings or related supplies and ...
Breaking Medicine Technology: