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

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."


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

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