At many transplant centers in the U.S., people who have a high body mass index (BMI) don't qualify for kidney transplant. The traditional cutoff is a BMI over 35. At Mayo Clinic, it has been 40. However, with obesity growing to affect 40% of the U.S. population and 60% of people needing a kidney transplant, Mayo Clinic developed the Kidney Transplant Metabolic Program to ensure that more people get the care they need.
Traditionally, transplant centers don't have resources to help people address factors that make them ineligible for transplant. Physicians typically instruct people with obesity to lose weight and return when they fit the criteria. However, this can be difficult for people to achieve as they are experiencing fatigue from their dialysis treatments.
Experts in the Kidney Transplant Metabolic Program take a more holistic approach to address the full array of needs a person with a high BMI and kidney disease faces. For instance, people with high BMIs often have comorbidities, such as:
- Sleep apnea
- Increased cancer risk
- Increased infection rates
- Increased frailty
The Kidney Transplant Metabolic Program identifies people with high BMIs early and consults with them about their comorbidities, risks and treatment options. The program offers bariatric surgery and other supports, such as dietary resources and mental health care, before transplant to address a high BMI and treat accompanying conditions. In some cases, these treatments stabilize kidney function, which can delay the need for a transplant for years, even permanently.
After transplant, the program will work with you to prevent the return of associated conditions, such as diabetes, and ensure that you stay healthy.
To treat you as a whole person and not just a disease, the Kidney Transplant Metabolic Program leverages Mayo Clinic's multidisciplinary team approach to complex care. The streamlined approach focuses a range of experts on you, including:
- Bariatric surgeon
- Transplant surgeon
- Bariatric nurses
- Transplant nurses
The strong collaboration among these groups means that you can complete your examinations and testing in two to three days rather than making countless visits.
The Kidney Transplant Metabolic Program is also well suited to help address cardiac issues that may arise in people with high BMIs with a kidney condition. People with high BMIs are at a high risk of cardiovascular diseases, as are people who need a kidney transplant. To address any cardiac issues you may face, experts in the Kidney Transplant Metabolic Program collaborate with experts in Mayo Clinic's departments of Cardiovascular Medicine and Cardiovascular Surgery, which U.S. News and World Report routinely names as one of the best in the country.
The same is true for people with diabetes (U.S. News and World Report ranks Mayo Clinic's diabetes care No. 1) and arthritis (U.S. News and World Report ranks Mayo Clinic's rheumatology care No. 3).