On 2015 Nov 15, NephJC - Nephrology Journal Club commented:

This paper was discussed on Sep 8th in the open online nephrology journal club, #NephJC, on twitter. Introductory comments, prepared by Hector Madariaga, are available at the NephJC [website](www.nephjc.com/obesity-and-transplant/). This controversial topic was discussed in detailed with more than 50 participants, including the authors of the paper (Jennifer McCaughan and Chris Hill) as well as nephrologists, transplant specialists, transplant surgeons, fellows and residents. The highlights of the tweetchat were:

• The authors did a commendable job in compiling the data for this review together, trying to answer this vexing question about the suitability of kidney transplantation in the obese individual with kidney failure, and provided useful quantitative data on clinical outcomes.

• The participants acknowledged the difficulties of obese patients losing weight and accessing bariatric surgery pre-transplant. The additional specific concern, which could not be assessed in this systematic review, is that these patients may be challenging for kidney transplantation surgery due to technical aspects (length of stay, wound complications, infections). Balancing equity and utility are crucial from a societal perspective.

• The consensus was that BMI is an imperfect criterion for kidney transplantation and that each case should be assessed individually. There was still a transatlantic difference, with the European discussants still being wary above a BMI of 40 kg/m2. A transcript and a curated (i.e. Storified) version of the tweetchat are available from the [NephJC website](www.nephjc.com/obesity-and-transplant/). Interested individuals can track and join in the conversation by following @NephJC or #NephJC, or visit the webpage at [NephJC.com](www.nephjc.com).

On 2015 Nov 15, NephJC - Nephrology Journal Club commented:

This paper was discussed on Sep 8th in the open online nephrology journal club, #NephJC, on twitter. Introductory comments, prepared by Hector Madariaga, are available at the NephJC [website](www.nephjc.com/obesity-and-transplant/). This controversial topic was discussed in detailed with more than 50 participants, including the authors of the paper (Jennifer McCaughan and Chris Hill) as well as nephrologists, transplant specialists, transplant surgeons, fellows and residents. The highlights of the tweetchat were:

• The authors did a commendable job in compiling the data for this review together, trying to answer this vexing question about the suitability of kidney transplantation in the obese individual with kidney failure, and provided useful quantitative data on clinical outcomes.

• The participants acknowledged the difficulties of obese patients losing weight and accessing bariatric surgery pre-transplant. The additional specific concern, which could not be assessed in this systematic review, is that these patients may be challenging for kidney transplantation surgery due to technical aspects (length of stay, wound complications, infections). Balancing equity and utility are crucial from a societal perspective.

• The consensus was that BMI is an imperfect criterion for kidney transplantation and that each case should be assessed individually. There was still a transatlantic difference, with the European discussants still being wary above a BMI of 40 kg/m2. A transcript and a curated (i.e. Storified) version of the tweetchat are available from the [NephJC website](www.nephjc.com/obesity-and-transplant/). Interested individuals can track and join in the conversation by following @NephJC or #NephJC, or visit the webpage at [NephJC.com](www.nephjc.com).