Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.135
Peer-review started: August 5, 2015
First decision: October 13, 2015
Revised: October 25, 2015
Accepted: December 17, 2015
Article in press: December 18, 2015
Published online: March 24, 2016
Processing time: 230 Days and 5.8 Hours
Core tip: Extremes of body mass index (BMI) appear to impact survival in kidney transplant recipients, but this effect appears to parallel that seen in the general population. Skin and soft-tissue complications, particularly wound infections and lymphocele formation, are higher among obese patients. In addition, the rate of delayed graft function is also higher, and contributes to longer length of stay following transplant in this population. New onset diabetes after transplant also appears to be influenced both by BMI at time of transplant as well as increasing BMI following transplant. Measures of central adiposity, such as waist-to-hip ratio, may enhance risk assessment. Bariatric surgery appears promising to aid in reducing excess weight both pre- and post-transplant, but further studies are needed. Obesity should not constitute an absolute contraindication to transplantation but individualized risk assessment is necessary.