Body Fat Percentage as a Marker of New-Onset Diabetes Mellitus After Kidney Transplantation

Tokodai, Kazuaki; Amada, Noritoshi; Kikuchi, Hiroyuki; Haga, Izumi; Takayama, Tetsuro; Nakamura, Atsushi

doi:10.1016/j.transproceed.2012.12.009

Cited by 16 publications

(9 citation statements)

References 34 publications

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“…Regarding the metabolic outcome parameters, increasing BMI shows a significant correlation with the development of NODAT and hypertension, which is not surprising, knowing that overweight and obesity are common risk factors for developing these comorbidities [ 92 , 98 ].…”

Section: Discussionmentioning

confidence: 99%

Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis

Lafranca

IJermans

Betjes

et al. 2015

BMC Med

178

132

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BackgroundWhether overweight or obese end stage renal disease (ESRD) patients are suitable for renal transplantation (RT) is often debated. The objective of this review and meta-analysis was to systematically investigate the outcome of low versus high BMI recipients after RT.MethodsComprehensive searches were conducted in MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and CENTRAL (the Cochrane Library 2014, issue 8). We reviewed four major guidelines that are available regarding (potential) RT recipients. The methodology was in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and written based on the PRISMA statement. The quality assessment of studies was performed by using the GRADE tool. A meta-analysis was performed using Review Manager 5.3. Random-effects models were used.ResultsAfter identifying 5,526 studies addressing this topic, 56 studies were included. We extracted data for 37 outcome measures (including data of more than 209,000 RT recipients), of which 26 could be meta-analysed. The following outcome measures demonstrated significant differences in favour of low BMI (<30) recipients: mortality (RR = 1.52), delayed graft function (RR = 1.52), acute rejection (RR = 1.17), 1-, 2-, and 3-year graft survival (RR = 0.97, 0.95, and 0.97), 1-, 2-, and 3-year patient survival (RR = 0.99, 0.99, and 0.99), wound infection and dehiscence (RR = 3.13 and 4.85), NODAT (RR = 2.24), length of hospital stay (2.31 days), operation duration (0.77 hours), hypertension (RR = 1.35), and incisional hernia (RR = 2.72). However, patient survival expressed in hazard ratios was in significant favour of high BMI recipients. Differences in other outcome parameters were not significant.ConclusionsSeveral of the pooled outcome measurements show significant benefits for ‘low’ BMI (<30) recipients. Therefore, we postulate that ESRD patients with a BMI >30 preferably should lose weight prior to RT. If this cannot be achieved with common measures, in morbidly obese RT candidates, bariatric surgery could be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0340-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis

Lafranca

IJermans

Betjes

et al. 2015

BMC Med

178

132

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“…Meta-analysis was performed in Revman 5.3 [4]. The effect estimate was calculated together with 95% CI, studies were weighted by sample size, and heterogeneity was assessed with an I 2 test.…”

Section: Methodsmentioning

confidence: 99%

Machine Perfusion for Abdominal Organ Preservation: A Systematic Review of Kidney and Liver Human Grafts

Bellini

Nozdrin

Yiu

et al. 2019

JCM

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Introduction: To match the current organ demand with organ availability from the donor pool, there has been a shift towards acceptance of extended criteria donors (ECD), often associated with longer ischemic times. Novel dynamic preservation techniques as hypothermic or normothermic machine perfusion (MP) are increasingly adopted, particularly for organs from ECDs. In this study, we compared the viability and incidence of reperfusion injury in kidneys and livers preserved with MP versus Static Cold Storage (SCS). Methods: Systematic review and meta-analysis with a search performed between February and March 2019. MEDLINE, EMBASE and Transplant Library were searched via OvidSP. The Cochrane Library and The Cochrane Central Register of Controlled Trials (CENTRAL) were also searched. English language filter was applied. Results: the systematic search generated 10,585 studies, finally leading to a total of 30 papers for meta-analysis of kidneys and livers. Hypothermic MP (HMP) statistically significantly lowered the incidence of primary nonfunction (PMN, p = 0.003) and delayed graft function (DGF, p < 0.00001) in kidneys compared to SCS, but not its duration. No difference was also noted for serum creatinine or eGFR post-transplantation, but overall kidneys preserved with HMP had a significantly longer one-year graft survival (OR: 1.61 95% CI: 1.02 to 2.53, p = 0.04). Differently from kidneys where the graft survival was affected, there was no significant difference in primary non function (PNF) for livers stored using SCS for those preserved by HMP and NMP. Machine perfusion demonstrated superior outcomes in early allograft dysfunction and post transplantation AST levels compared to SCS, but however, only HMP was able to significantly decrease serum bilirubin and biliary stricture incidence compared to SCS. Conclusions: MP improves DGF and one-year graft survival in kidney transplantation; it appears to mitigate early allograft dysfunction in livers, but more studies are needed to prove its potential superiority in relation to PNF in livers.

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“…A significant proportion of people with a normal BMI (18.5‐24.9 kg/m 2 ) has been shown to have pre‐diabetes, undiagnosed diabetes, and hypertension . Moreover, the increase in body fat has been shown to represent an independent risk factor for new‐onset diabetes after transplantation, a serious metabolic complication that can follow organ transplantation …”

Section: Diabetes and Body Fat: A Long‐standing Liaisonmentioning

confidence: 99%

Diabetes, body fat, skeletal muscle, and hypertension: The ominous chiasmus?

Shu

Matarese

Santulli

2018

J of Clinical Hypertension

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Body Fat Percentage as a Marker of New-Onset Diabetes Mellitus After Kidney Transplantation

Cited by 16 publications

References 34 publications

Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis

Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis

Machine Perfusion for Abdominal Organ Preservation: A Systematic Review of Kidney and Liver Human Grafts

Diabetes, body fat, skeletal muscle, and hypertension: The ominous chiasmus?

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