Kidney Week

Abstract: TH-PO991

The Impact of Recipient BMI on Outcomes after Kidney Transplantation

Session Information

• Transplant Recipient Education, Adherence, and Novel Risk Factors for Graft Loss
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Arshad, Adam, University of Birmingham, Stoke on Trent, United Kingdom

Adam Arshad,

• Chappelow, Imogen, University of Birmingham, Stoke on Trent, United Kingdom

Imogen Chappelow,

• Hodson, James, Biostatistics, Birmingham, United Kingdom

James Hodson,

• Nath, Jay, University Hospital Birmingham, Birmingham, United Kingdom

Jay Nath,

• Sharif, Adnan, Queen Elizabeth Hospital, Birmingham, Birmingham, United Kingdom

Adnan Sharif,

Background

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.

Methods

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).

Results

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).

Conclusion

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.