Abstract: TH-PO991

The Impact of Recipient BMI on Outcomes after Kidney Transplantation

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational


  • Arshad, Adam, University of Birmingham, Stoke on Trent, United Kingdom
  • Chappelow, Imogen, University of Birmingham, Stoke on Trent, United Kingdom
  • Hodson, James, Biostatistics, Birmingham, United Kingdom
  • Nath, Jay, University Hospital Birmingham, Birmingham, United Kingdom
  • Sharif, Adnan, Queen Elizabeth Hospital, Birmingham, Birmingham, United Kingdom

A high recipient BMI is still considered a contraindication for transplantation across many centres. However, there is inconsistent evidence as to the influence of recipient BMI on post-transplant outcomes.


Data from National Health Service blood and transplantation was analysed for all patients receiving deceased donor kidney transplantations between January 2003 to January 2015. Transplants were separated into 5 categories depending on the recipient’s body mass index (BMI) (kg/m2): < 18.50 (underweight), 18.50 – 25.00 (normal), 25.01 – 30.00 kg/m2 (overweight), 30.01 – 35.00 (obese) and > 35.00 (morbidly obese).


Data for 11,916 transplants were analysed (recipient BMI < 18.50 kg/m2 in 300, 18.50 kg/m2 – 25.00 kg/m2 in 4730, 25.01 kg/m2 – 30.00 kg/m2 in 4270, 30.01 kg/m2 – 35.00 kg/m2 in 2132 and > 35.00 kg/m2 in 480). In multivariable analysis, obese and morbidly obese recipients were seen to have impaired graft outcomes, with risk-adjusted rates of delayed graft function of 33.0% and 33.1%, relative to 25.3% in normal BMI recipients (p < 0.001). Obese and morbidly obese BMI were also found to be at increased risk of graft failure (death-censored), with adjusted rates of 1-year and 5-year (in brackets) graft survival of 92.8% (86.0%) and 91.6% (84.4%), relative to 94.4% (88.2%) in normal BMI recipients (p < 0.001).
Interestingly, the only group found to be at increased risk of death were the underweight recipients, with adjusted 1- and 5- year survival of 95.1% and 83.5%, compared to 97.0% and 90.6% in normal BMI recipients and 97.2% and 89.7% for morbidly obese recipients (p = 0.005).


Raised recipient BMI increases the risk of graft failure in long-term. Overall, methods to reduce this increased risk of graft failure should be explored.