Obesity, Surgical Site Infection, and Outcome Following Renal Transplantation

Lynch, Raymond; Ranney, David N.; Cai, Sanjun; Lee, Dennis S.; Samala, Niharika; Englesbe, Michael J.

doi:10.1097/sla.0b013e3181b4ee9a

Cited by 242 publications

(190 citation statements)

References 18 publications

Supporting

Mentioning

171

Contrasting

Unclassified

Order By: Relevance

“…Currently over one-third of the United States'population is obese [24]. There is a growing body of literature that supports the notion that there is a higher risk for preoperative complications including greater risk for wound infections, airway-related complications, deep vein thrombosis, and pulmonary embolus [6,[25][26][27][28][29][30][31]. Foley et al [32] was the first to describe the MI-TLIF using tubular retractors via a muscle splitting approach to decrease the amount of soft tissue injury.…”

Section: Discussionmentioning

confidence: 99%

The effect of obesity on patient-reported outcome measures after minimally invasive transforaminal lumbar interbody fusion

McAnany¹,

Overley²,

Andelman³

et al. 2015

Integr Obesity Diabetes

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

The effect of obesity on patient-reported outcome measures after minimally invasive transforaminal lumbar interbody fusion

McAnany¹,

Overley²,

Andelman³

et al. 2015

Integr Obesity Diabetes

View full text Add to dashboard Cite

show abstract

“…27 Pretransplant dialysis is a known risk factor for wound complications. 28 Surgical site infections and impaired wound healing also can lead to wound dehiscence and incisional hernia formation. These sequelae are medically, financially, and psychologically costly.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Shaikh

Karipineni

Parsikia

et al. 2015

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Grafts from extended criteria donors, donors after cardiac death, and elderly donors have an increased risk of delayed graft function, lower graft survival, longer hospital stay, higher costs, and increased medical sequelae. A modifiable risk factor for delayed graft function may be the performance of dialysis on the same day as renal transplant. We reviewed our institutional experience to determine whether dialysis performed within 24 hours of engraftment increased the incidence or length of delayed graft function. Materials and Methods: We retrospectively reviewed our kidney transplants performed between 2008 and 2012. Preemptive transplants, transplants associated with peritoneal dialysis, potassium > 5 mmol/L, or living donors, and cases with insufficient information were excluded. Data collected included demographic, biochemical, donor, operative, and outcome variables (length of stay, length of delayed graft function, rejection, and a composite unfavorable outcome comprising cardiac and infectious events). Transplants that were associated with hemodialysis within 24 hours before transplant (study group) were compared with the remainder of the cohort (control group). Results: A total of 205 renal transplants were reviewed. There were 144 of 205 transplants (70.24%) in the study group, and the others comprised the control group. The rate of delayed graft function was 31% for the study group and 29% for control groups (P = .4959). Mean length of delayed graft function was 5.8 days for the study group and 6.1 days for control group (P = .7323). Delayed graft function risk factors such as donor age, terminal creatinine, and machine perfusion rate were similarly distributed across both groups. Conclusions: Normokalemic patients who did or did not undergo dialysis within 24 hours before transplant had equivalent incidence and duration of delayed graft function, graft outcomes, and patient outcomes. Therefore, dialysis within 24 hours before transplant is unnecessary in the setting of normokalemia.

show abstract

“…Although data specific to the paediatric population are scarce, in adult recipients the incidence of surgical site infection appears to dramatically increase with rising BMI and has been reported to reach 40 % in the very morbidly obese transplant patients [14]. In both paediatric and adult settings, comparatively avascular adipose tissue combined with chronic, pretransplantation uraemia and inflammation impairs wound healing and increases the incidence of wound complications, including a fourfold increased risk of wound infection [15].…”

Section: Surgical Complicationsmentioning

confidence: 99%

Paediatric obesity and renal transplantation: current challenges and solutions

Terrace

Oniscu

2015

Pediatr Nephrol

View full text Add to dashboard Cite

The increased incidence of obesity in the paediatric population poses significant challenges to renal transplantation. Whilst the body mass index appears to be widely used as a measure of obesity in adults, there are no standardised definitions in the paediatric population, making comparative analyses difficult. In the paediatric transplant population, obesity is associated with an increased incidence of surgical complications, diabetes, hyperlipidaemia and cardiovascular morbidity, leading to diminished graft function and impacting patient and graft survival. Management of obesity in renal transplantation requires multiple interventions starting with lifestyle and behavioural modification combined with medical and possibly surgical therapies, representing a unique challenge in the childhood setting. In this review we discuss the current challenges of obesity and potential solutions in the setting of paediatric transplantation.

show abstract

Obesity, Surgical Site Infection, and Outcome Following Renal Transplantation

Cited by 242 publications

References 18 publications

The effect of obesity on patient-reported outcome measures after minimally invasive transforaminal lumbar interbody fusion

The effect of obesity on patient-reported outcome measures after minimally invasive transforaminal lumbar interbody fusion

Untitled

Paediatric obesity and renal transplantation: current challenges and solutions

Contact Info

Product

Resources

About