Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Minimizing Barriers for Kidney Transplant Candidates with Obesity

Minimizing Barriers for Kidney Transplant Candidates with Obesity

Video Transcription

Video Summary

Dr. Ed Wong discusses how obesity (using BMI as a proxy) affects access to kidney transplantation, noting nearly half of U.S. waitlisted patients now have BMI ≥30. Most transplant programs use BMI thresholds to decide evaluation and listing, often around BMI 40, and some make no exceptions—largely due to concerns about post-operative complications and reported outcomes. However, early post-transplant survival differences by BMI are small, and transplantation still confers a survival advantage over dialysis even for obese patients. Evidence that pre-transplant weight loss improves outcomes is weak and may even correlate with worse outcomes. Lifestyle changes help but are usually insufficient alone; medications and bariatric procedures may be needed, ideally supported by transplant-embedded weight management.

Asset Subtitle

Edmund Huang

Meta Tag

Module TRX

Speaker Edmund Huang

Keywords

obesity and kidney transplantation

BMI thresholds for transplant listing

post-transplant outcomes in obese patients

pre-transplant weight loss evidence

transplant-embedded weight management (medications and bariatric surgery)