Too high BMI for a transplant

[Bassetmommer]

Has any one been told they were not a candidate for a transplant because their BMI was too high? What did you so about it?

[TaffyTwoshoes27]

I was told at my transplant facility that the centers have their own BMI ranges. I guess it depends on other health factors. You question does not give me an idea whether this is a donor who was turned down or a kidney patient attempting to be listed for a kidney. I keep working hard to keep my weight within the BMI range for my transplant center in Atlanta.

[Hidden in reply to TaffyTwoshoes27]

I'm not aware of any different numbers for BMI between transplant facilities and standard physician usage. However, what to do about it is pretty much generalized. I've included a link to the National Kidney Foundation article on the issue. Regarding the specifics of BMI numbers, ask the transplant facility in question for a chart that they use to give a target for weight loss.

kidney.org/content/your-wei...

[Kbressler NKF Peer Mentor NKF Ambassador in reply to Hidden]

If a patients BMI is high it indicates that they are over weight. Being overweight would put the patient at risk for surgery. Ideal body weight or BMI is just one of several parameters used to gauge probable successful transplantation.

[Hidden in reply to Kbressler]

I know what BMI is and how it is used. I'm not familiar with the comment made about transplant facilities using a different BMI number for potential transplant patients. BMI is not always indicative of being overweight. A bodybuilder would have an excessively high BMI but not have extra fat stored. Thanks for sharing.

[TaffyTwoshoes27 in reply to Hidden]

I was told by my transplant center that their BMI range is a little more flexible (and higher BMIs accepted, particularly if other health requirements are met or exceeded) for the DONOR, not the patient. I was told some centers will go as high as 40 BMI for DONORS if they otherwise meet all of the health requirements. My dialysis clinic RN handling nutrition said transplant centers may conversely reject patients who have a BMI too low (which may imply a lack of ability to maintain a healthy diet and weight). If the BMI is too low, odds of a successful transplant concern the transplant facility.

[Hidden in reply to TaffyTwoshoes27]

Thanks for the explanation. I'm not too invested in this area at this time so it's good to have others who are and can provide clarification and insight. It's appreciated by me and I'm sure many others.

[Jayhawker in reply to TaffyTwoshoes27]

My transplant center has said the same. In fact my transplant center transplants patients with higher BMIs than another transplant center in the metropolitan area where I live. In addition to some variation in required BMI, some centers will transplant patients considered higher risk with other conditions. So there are variations across centers.Jayhawker

[KidneyCoach NKF Ambassador]

Yes I was told this once by a local transplant center. I then went on to Mayo Clinic in MN and was listed there. They evaluate patients individually and don't use arbitrary BMI limits. Over a year or two I lost over 150 lbs on my own and was able to transfer my time and points back over to a local center. It takes a lot of effort and determination to find a transplant center willing to consider each person as an individual. A Chicago transplant center has no real BMI limits as they use robotic assisted surgery which lowers risks. Some transplant centers have lower BMI limits (strict) while others don't really use BMI as a risk indicator. Each transplant center will have its own unique BMI limits so they will vary from center to center. You could be great at once center and yet at another need to lose 30 lbs. I often feel as though in these cases the centers use BMI to weed out potential transplant candidates from their programs so as to get the best outcomes and statistics rather than really help others get a transplant. Its a sad state of affairs but keep trying. Blessings

[Hidden in reply to KidneyCoach]

Excellent points made about the use of the BMI. Thanks

[TaffyTwoshoes27 in reply to KidneyCoach]

I agree with the "statistics" opinion. Doctors and hospitals want positive results and don't like taking the "borderline" cases. Sad.

[steve680 in reply to KidneyCoach]

That makes sense given that transplant centers are rated on their success rates. I'm listed with one where patients who smoke or weigh more than 20% over their ideal body weight won't be listed as "active" on the waiting list.

[Sdtagoo]

There are so many waiting for a transplant, the centers are probably looking at obesity as a high risk for success (anything over your normal BMI is considered obesity). They probably figure if there are healthier people taking care of themselves, a transplant would not be wasted. I would definitely get my BMI under control if that is the issue.

[Bassetmommer NKF Ambassador in reply to Sdtagoo]

Just because someone does not meet the insurance company's generated statistic for weight, it does not mean they are unhealthy. And over weight people do take care of themselves. There are many factors that cause weight gain and everyone's body is not the same.

[Sdtagoo in reply to Bassetmommer]

That is true regarding other reasons for weight gain. My brother just had a transplant and he had to lose weight to be accepted because he was extremely overweight. Obesity Carries it's own set of problems making a transplant riskier. Even a doner cannot be overweight. When I found out I had CKD and my BMI placed me in the obesity range, I immediately lost weight (40 lbs.) and kept it off to improve my chances for a transplant should it ever come to that. In saying this, I also have several other health issues besides my kidneys that cause weight gain and have worked with my doctors to find the right medications and diet to help me. It's a daily struggle but I see my health as a priority and remind myself of that each day. My point is that insurance has less to do with it than the medical doctors that utilize medical guidelines (see Mayo Clinic website & National kidney association) to determine out of thousands needing kidneys, which patient is healthy enough for the transplant to "take" and live a better life afterwards. No offense intended toward your personal situation as I do not know you.

[Bassetmommer NKF Ambassador]

No personal offense taken. I am just an advocate for unbiased and individual medical treatment for all. Good for you and your brother for being able to lose weight in order to meet the needed criteria.

[steve680]

High BMI is usually associated with type 2 diabetes which can also be a disqualification depending how well is it managed. You could ask the transplant facility if they have an A1C which is considered too high for transplant. My BMI a few years ago was too high so I stopped drinking alcohol and I lost a lot of weight (50 pounds). My BMI is now in acceptable ranges (23).