title: Pancreas transplantation considering the spectrum of body mass indices.
abstract: BACKGROUND
  In kidney, liver, heart, and lung transplantation, extremes of body mass index (BMI) have been reported to influence post-operative outcomes and even survival. Given the limited data in pancreas transplantation, we sought to elucidate the influence of BMI on outcomes.
  
  
  METHODS
  We reviewed 139 consecutive pancreas transplants performed at our institution and divided them into four categories based on BMI: underweight (≤18.5 kg/m(2)), normal (18.6-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)). Parameters analyzed included post-operative complications, early graft loss, one-yr acute rejection rate (AR), non-surgical infections, and survival.
  
  
  RESULTS
  Demographic data were similar between the groups. Compared with normal, only obese patients trended toward more post-operative complications (p = 0.06). Underweight and obese patients had significantly more post-operative infectious complications than normal (p = 0.0005 and p = 0.03, respectively). Obese patients had more complications requiring percutaneous drainage compared with normal (p = 0.03). Overweight and obese patients had significantly more complications requiring re-laparotomy (p = 0.03 and p = 0.048, respectively). Early graft loss, AR, non-surgical infections, and patient and graft survival rates were not different between normal and underweight, overweight, or obese patients (p > 0.05).
  
  
  CONCLUSIONS
  Extremes of BMI were associated with increased morbidity. Donors and recipients should be carefully selected to maximize potential for successful outcomes.
authors.affiliation: Division of Transplantation, Department of Surgery, Weill Cornell Medical College, New York, NY, USA. cafaneh@gmail.com
authors.forename: Cheguevara
authors.initials: C
authors.lastname: Afaneh
authors.forename: Barrie
authors.initials: B
authors.lastname: Rich
authors.forename: Meredith J
authors.initials: MJ
authors.lastname: Aull
authors.forename: Choli
authors.initials: C
authors.lastname: Hartono
authors.forename: Sandip
authors.initials: S
authors.lastname: Kapur
authors.forename: David B
authors.initials: DB
authors.lastname: Leeser
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D006084:Graft Rejection / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality; D010359:Patient Readmission; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult