DC Metro Area Medical Malpractice Law Blog

Obese patients with kidney disease face longer waits than most patients for transplant organs, and those extended waits jeopardize their safety and health, according to researchers at Johns Hopkins University.  Their study was recently published in the Journal of the American Society of Nephrology.  According to the study, billing practices and regulatory measures that require the reporting of surgical outcomes discourage medical facilities and physicians alike from treating obese patients -- patients more at risk than most of suffering expensive surgical complications and requiring extended hospital stays.

Although placement on a transplant list tends to imply that safeguards exist to ensure equitable distribution of available transplant organs, data clearly indicates that current kidney allocation protocol are biased against obese patients.  According to authors of the study, the data are explainable by economic considerations:  Medicare, the primary insurer for kidney transplants, pays a flat rate for the operation, regardless of complications that may be specific to individual cases.  Because obese patients are more likely to require extended post-operative stays, and are less likely to experience a swift, successful recovery, transplant centers are under financial pressure to avoid these types of patients, in favor of those who are less likely to jeopardize the profitability of the medical center. 

Researchers analyzed data from more than 130,000 men and women on the national kidney transplant list between 1995 and 2006.  After adjusting for additional health factors, they determined that the likelihood of receiving a kidney transplant decreased by 4% for overweight patients, by 7% for obese patients, 28% for severely obese patients, and by 44% for patients who were morbidly obese. 

From 1995 to 2005, the number of severely obese patients added to the national transplant list increased by 310%.  The number of morbidly obese patients grew by 247%.  The number of transplant candidates of normal weight expanded by only 33%. 

Previously on the DC Metro Area Medical Malpractice Law Blog, we have posted articles related to:

• A news story regarding DC-area transplant centers in danger of losing certification
• The risks of gastric bypass surgery
• An article explaining why bariatric surgery is good for business, though not always good for patients

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