The effects of body mass index on graft survival in adult recipients transplanted with single pediatric kidneys.
BACKGROUND
There is insufficient data on the impact of recipient body mass index (BMI) on the long-term graft survival of adult patients transplanted with single pediatric kidneys.


METHODS
We performed a retrospective analysis of adult patients transplanted with single pediatric kidneys at our center. The recipients were classified into 2 groups: group 1 (BMI > or =30) and group 2 (BMI <30). Donor/recipient demographics, postoperative outcomes and survival rates were compared between the 2 groups.


RESULTS
There was no significant difference in donor/recipient demographics between the 2 groups. In group 1, the death-censored graft survival (DCGS) at 1, 3 and 5 years was 90% at all 3 time points, and in group 2 it was 86, 68 and 60%, respectively (p = 0.05). The mean glomerular filtration rate (with standard deviation in parentheses) at 1, 3 and 5 years was, respectively, 55 (15), 59 (19) and 55 (28) ml/min for group 1, compared to 65 (28), 69 (23) and 67 (20) ml/min in group 2 (p = NS). Multivariate analysis revealed a hazard ratio of 5.12 (95% confidence interval 1.06-24.7; p = 0.04) for graft loss in nonobese patients when compared to obese patients. Obese patients had an increased risk for acute rejections within the first month of transplant (p = 0.02).


CONCLUSIONS
Patients with a BMI > or =30 transplanted with single pediatric kidneys have better DCGS rates when compared to nonobese patients.
Balamuthusamy
Saravanan
S
Tulane Abdominal Transplant Institute, Tulane University Health Sciences Center, 1430 Tulane Avenue SL-45, New Orleans, LA 70112, USA. sbalamut@tulane.edu
Paramesh
Anil
A
Zhang
Rubin
R
Florman
Sander
S
Shenava
Rajesh
R
Islam
Tareq
T
Wagner
Janis
J
Killackey
Mary
M
Alper
Brent
B
Simon
Eric E
EE
Slakey
Douglas
D
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D051799:Delayed Graft Function / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology*; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D011507:Proteinuria / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
D007166:Immunosuppressive Agents