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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Kidney transplantation (Tx) is the best form of renal replacement therapy for most patients with end stage kidney disease; however, increased body mass index (BMI) is known to be associated with an increased risk of complications. We specifically aimed to evaluate both early complications (intraoperative and immediate postoperative events) and late surgical complications in the post-transplant course, in order to provide a more comprehensive understanding of how recipient BMI impacts surgical outcomes in kidney transplant patients.
We did an observational, retrospective study including 420 adult Tx recipients at Aarhus University Hospital between January 2019 to August 2023. Follow-up period was from the day of Tx until 6 months after that. Data was obtained from patient’s electronic journals and the Scandiatransplants database.
BMI was measured at the time of recipient’s approval to Tx, at the day of Tx and 6 months after the surgery. Patients were divided according to their BMI at Tx day in four groups: BMI ≤18.5 (N=10), BMI 18.5-24.9 (N=174), BMI 25-29.9 (N=170) and BMI ≥30 (N=66).
The average age of the patients at Tx was 52 years old. 270 (64.3%) of all recipients were men. 139 patients (33.1%) received kidney from living donors. 158 patients (37.6%) were in pre-dialysis stadium. 85 of recipients (20.2%) had Diabetes Mellitus (DM) before Tx. Follow up after 6 months post-Tx revealed 47 (14.2%) de novo DM cases, and it was more common with them that had BMI>30 (28.6%).
The average BMI of recipients was 25.4 kg/m2 at the time of approval to Tx. Our population had almost stable BMI at the time of Tx and 6 months after that. Patients with BMI>30 had longer duration of Tx surgery and more early surgical complications especially perioperative bleeding and thromboembolic events (Table 1.).
Patients with BMI>30 had also longer hospitalization. Obese recipients had higher rates of late surgical complications, especially wound dehiscence and lymphocele (Table 2.).
Table1. Intraoperative surgical complications
OP-time (minutes)
Surgical complications
(all types) (%)
Vascular complications (%)
Thromboembolic complications (%)
Urological complications (%)
Perioperative bleeding (%)
All cases
173
96 (22.9)
3 (0.7)
9 (2.1)
0 (0.0)
88 (20.9)
BMI<18.5
142
3 (30.0)
BMI 18.5 to 24.5
161
35 (20.1)
1 (0.6)
3 (1.7)
32 (18.4)
BMI 25 to 29.9
171
36 (21.2)
3 (1.8)
33 (19.4)
BMI ≥30
216
22 (33.3)
2 (3.0)
3 (4.5)
20 (30.3)
Table2. Postoperative surgical complications (within 2 months after Tx)
Late surgical complications
(all types)
(%)
Postoperative bleeding (%)
Vascular & Thromboembolic complications (%)
Abdominal surgical complications (%)
Wound dehiscence & Site infection (%)
Lymphocele & Urological complications (%)
111 (26.4)
68 (16.2)
8 (1.9)
17 (4.0)
14 (3.3)
45 (10.7)
2 (20.0)
1 (10.0)
43 (24.7)
27 (15.5)
2 (1.1)
6 (3.4)
5 (2.9)
18 (10.3)
44 (25.9)
26 (15.3)
4 (2.3)
9 (5.3)
6 (3.5)
15 (8.8)
21 (31.8)
13 (19.7)
11 (16.6)
Recipients with BMI>30 had longer surgical time as well as more early and late complications after Tx. Also, this was associated with a greater incidence of delayed graft function and post-Tx DM, but not with graft survival at 6 months.
