Kidney Transplant Metabolic Program

Sep 24, 2021 | Kristin Eggebraaten | @keggebraaten

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 for patients’ weight is a BMI over 35. At Mayo Clinic, that cutoff 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.

In the past, transplant centers didn’t have the resources to assist patients in addressing the reasons why they didn’t qualify for transplant, such as obesity. Most doctors asked patients to return home, lose their excess weight, and come back to the center once they met the criteria. As those with kidney disease know, weight loss can be very difficult while suffering the fatigue and general feelings of being unwell that are typically associated with kidney disease.

Mayo Clinic has developed a program that addresses a holistic approach to people with a high BMI and kidney disease. Two physicians at Mayo Clinic in Rochester, Minnesota, Aleksandra Kukla, M.D., a nephrologist, and Tayyab (Ty) S. Diwan, M.D., an abdominal transplant surgeon, have paved the way to transplant for patients with higher BMIs, using bariatric surgery to increase access. People who high BMI often suffer from diabetes, hypertension, sleep apnea and other conditions that make them increased risk for a kidney transplant. This new program tries to identify obese patients early and offers support such as bariatric surgery, dietary help, and mental health care before transplant to treat these high-risk conditions. “The team strives to identify patients with high BMI early, offering consult on risk and treatment. This alignment of bariatric and transplant disciplines is uncommon among medical centers,” says Dr. Kukla. After the transplant, this program will continue to work with patients who need assistance staying healthy.

Mayo’s kidney transplant team for this high BMI population of patients includes the usual nephrologist, transplant surgeon, and RN care coordinator, but it also includes a bariatric surgeon and nurse, an endocrinologist, and a high level of diet and psychological care necessary to help patients lose the weight and cope with their illness in the healthiest way possible.

Creating this new program allows patients to complete their evaluation and consultations in two to three days, rather than making countless visits to the clinic. Our team creates the best plans with attention to individual needs of each patient.

Have you been turned down for kidney transplant due to your weight? If you are interested in this program, you can learn more on our web page or contact us directly for more information!

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