Analysis Shows Obese Wait Longer for Organ Transplants
Dr. Dorry Segey of Johns Hopkins University, a transplant surgeon, recently completed a study showing people who are obese wait longer for a transplant than average weight people. The research was based on an analysis of records from 132,353 patients on the national kidney transplant waiting list between 1995 and 2006. The findings were published in the Journal of the American Society of Nephrology. The reason assigned to the discrimination is that the very obese have a greater risk for complications. The study showed that morbidly obese patients who average about 100 pounds over their ideal weight were 44 percent less likely to get a transplant than normal weight patients. Those just slightly less obese were 28 percent less likely to get a transplant. Dr. Segev argues that once someone has been accepted for a waiting list, the patient should progress to the top normally. He also believes the doctors and transplant staff do not consciously choose slimmer candidates over their obese patients. “I don't think any of this is conscious,” Segev said. “It would be hard to imagine any of us in our field would deliberately act against the welfare of our patients. That's not what we do, but there are all sorts of subconscious forces that are happening and there's clearly an unintended bias in practice.” He explains there may be two factors creating the bias. First the main insurer for kidney transplants, Medicare, pays a fixed rate regardless of the difficulty of each case, meaning the transplant hospital eats the added costs for complications. Second, transplant centers with lower survival rates risk losing Medicare funding. With American society increasingly gaining weight and entering the ranks of the medically obese, the implications of the study are worrisome.
