Obesity May Up Transplant Wait

According to new research from Johns Hopkins University, the wait for a kidney transplant is longer for obese patients.

The new study, which was published Dec. 19 on the website of the Journal of the American Society of Nephrology, reveals that morbidly obese patients -- those more than 100 pounds overweight -- face a median wait of five years on the list, compared to three for a person of normal weight.

Dorry Segev, a transplant surgeon who led the study, said that economic factors play a role in the disparity. According to Segev, Medicare pays a set amount for a transplant, regardless of variables that include a patient’s overall health, length of stay and the difficulty of the operation. Since Medicare is the principal insurer for kidney transplants, this often works against obese patients, who often require extra care both during and after the transplant procedure.

These factors may force transplant centers to avoid operating on obese individuals, since a lower surgical survival rate could mean less Medicare funding for the center, he said.

From 1995 to 2005, the number of overweight patients on the United Network for Organ Sharing waiting list has increased by 310 percent, reflecting the rising rate of obesity in the U.S. population.  In contrast, the number of people of normal weight added to the list showed only a 33 percent increase.

The researchers analyzed data from 132,353 men and women with kidney disease who were on the United Network for Organ Sharing deceased-donor kidney transplantation list from 1995 to 2006 in the United States.

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Posted February 4, 2008