title: Excessive weight gain in cardiac transplant recipients.
abstract: BACKGROUND
  Substantial weight gain frequently occurs after cardiac transplant (CT) and increases the risk of secondary disease. It is unclear, however, if weight gain after CT is related to glucocorticoid immunosuppressive therapy.
  
  
  METHODS
  A retrospective chart review was performed on the first 200 patients undergoing CT and the first 200 patients undergoing renal transplant (RT) at Columbia Presbyterian Medical Center, starting in January 2000. Patients who survived 1 year and had their weight recorded at transplant were included in the study. Rejection episodes and prednisone treatment was recorded for CT patients. Regression analysis was used to determine predictors of weight gain.
  
  
  RESULTS
  A total of 158 CT patients and 128 RT patients were included in the data analysis. The weight of CT patients at time of transplant was (mean +/- SD) 76.3 +/- 14.6 kg and increased by 10.3 +/- 10.6 kg (p < 0.05) by 1-year post-transplant. Pre-transplant weight of the RT patients was 74.1 +/- 20.1 kg; by 1-year post-RT, weight increased by 3.5 +/- 8.6 kg (p < 0.05). The weight gain in CT patients was significantly greater than in the RT patients (p < 0.001). Post-transplant weight change in multiple regression models was related to age, gender (male) and transplant type (cardiac), but not to prednisone dose or pre-transplant weight.
  
  
  CONCLUSIONS
  CT results in substantial post-surgical weight gain, which is greater than that observed for RT. Overweight and obesity development was not related to prednisone dose alone. This observation may have important clinical and research implications.
authors.affiliation: Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
authors.forename: Jill J
authors.initials: JJ
authors.lastname: Williams
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lund
authors.forename: John
authors.initials: J
authors.lastname: LaManca
authors.forename: Chandra
authors.initials: C
authors.lastname: Kunavarapu
authors.forename: David J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: Stanley
authors.initials: S
authors.lastname: Heshka
authors.forename: Steven B
authors.initials: SB
authors.lastname: Heymsfield
authors.forename: Donna M
authors.initials: DM
authors.lastname: Mancini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015430:Weight Gain
chemical_list: D007166:Immunosuppressive Agents; D011241:Prednisone