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Body Mass Index: A Key Factor in Surgical Site Infections After Kidney Transplantation?
Mohamed El-Mahrouk1, Raphaela Sorgnitt1, Gerold Schwantzer2
1Division of General, Visceral and Transplantation Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
International Wound Journal
|April 7, 2026
Summary
Kidney transplant patients face high surgical site infection (SSI) risks. Higher Body Mass Index (BMI) significantly increases SSI odds, particularly with Staphylococcus and Enterococcus infections, necessitating tailored prophylaxis.
Area of Science:
- Transplantation immunology and infectious diseases.
- Surgical site infection (SSI) epidemiology and risk factors.
Background:
- Kidney transplant recipients are vulnerable to surgical site infections (SSIs) due to immunosuppression and complex procedures.
- Understanding risk factors like Body Mass Index (BMI) is crucial for preventing post-transplant complications.
Purpose of the Study:
- To investigate the association between BMI and SSI risk in kidney transplant recipients.
- To identify common pathogens responsible for SSIs in this patient population.
Main Methods:
- Retrospective analysis of 230 kidney transplant patients from 2017-2019.
- Data collection on patient demographics, BMI, surgical revisions, and SSI occurrence.
- Microbiological analysis of wound swabs from patients who developed SSIs.
Main Results:
- SSIs occurred in 19.6% of patients and were significantly associated with surgical revision and higher BMI (p=0.027).
- A BMI ≥ 28.1 tripled the odds of SSIs (OR=3.0; p=0.001).
- Staphylococcus and Enterococcus infections were more prevalent in patients with BMI > 28.1.
Conclusions:
- SSIs are a frequent complication in kidney transplant recipients, strongly linked to elevated BMI.
- Current prophylactic antibiotic regimens may be insufficient for obese patients, requiring personalized strategies.
- Higher BMI is an independent risk factor for SSIs post-kidney transplantation.
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