Abstract: TH-PO993

Is Body Mass Index a Significant Independent Risk Factor for Graft Failure and Patient Death in the Modern Immunosuppressive Era?

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Shin, Ho Sik, Harvard Medical School,BWH,Transplantation Research Center, Boston, United States
  • Chandraker, Anil K., Harvard Medical School,BWH,Transplantation Research Center, Boston, Massachusetts, United States
Background

In previous studies, kidney transplant recipients with high body mass index (BMI) had inferior or superior outcomes compared to patients with lower BMI, and thus it remains unclear whether BMI is a significant independent risk factor for graft failure and patient death in the modern immunosuppressive era. We used United Network for Organ Sharing (UNOS) data to determine whether obesity affects patient and graft outcome following kidney transplantation.

Methods

From the UNOS database, we identified patients who underwent primary kidney-only transplantation between 1987 and 2016. The study sample consisted of 69,749 from 1987-1999 and 197,986 from 2000-2016. We correlated BMI with graft and patient survival, and created multivariate models to evaluate the independent effect of BMI on graft and patient outcomes, adjusting for factors known to affect graft success and patient survival.

Results

Mean BMI shifted from 25 kg/m2 in 1987-1999 to 27 kg/m2 in 2000-2016. Higher BMI was associated with significantly worse graft, patient and patient with functioning graft survival from 1987-1999. Lower and higher BMI were also associated with significantly worse graft, patient and patient with functioning graft survival from 2000-2016. In the same BMI group, graft and patient survival rates from 2000-2016 were higher than in 1987-1999.Cox regression modeling hazard ratios showed that obesity also increased the risk of graft failure and patient death.

Conclusion

BMI is a significant independent risk factor for graft failure and patient death in the modern immunosuppressive era.