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Lookup NU author(s): Dr Ruth Owen, Dr Emily ThompsonORCiD, Dr Sam Tingle, Dr Ibrahim Ibrahim, Professor Derek Manas, Steven White, Professor Colin Wilson
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Background: In many transplant centres, a recipient Body Mass Index (BMI) >30kg/m2would be considered a contraindication for pancreas transplantation. This study aims to investigate the impact of recipient BMI on graft outcomes after pancreas transplantation.Methods: Retrospective data on all UK solid organ pancreas transplants from 1994 - 2016 were obtained from the NHSBT UK Transplant Registry, n=2618. Cases missing BMI data were excluded, resulting in a final cohort of n=1452. Graft and patient survival analysis were conducted using Kaplan-Meier plots and Cox regression models.Results: The mean recipient BMI was 24.8kg/m2 (±2.4). There were 507 overweight (BMI 25-29.9) and 146 obese (>30) recipients receiving pancreas transplants. Univariate analysis showed no statistically significant difference between overweight BMI categories compared with normal BMI (18.5-24.9kg/m2). Multivariate analysis revealed increasing recipient BMI had a significant impact on graft survival (p=0.03, HR 1.04, 95%CI 1.00, 1.08). Receiver Operating Characteristic (ROC) curve analyses revealed no value of BMI that provided both specific and sensitive discrimination between death and survival of both grafts or patients. Recipients on dialysis with a BMI >30kg/m2 had a statistically significant decrease in both graft (p=0.002) and patient survival (p=0.015).Conclusions: Analysis of available UK Pancreas data has shown recipient BMI is an independent risk factor for patient survival after transplantation. However, we have been unable to define a specific cut-off value above which patients have poorer outcomes. Obese patients on haemodialysis had the poorest graft survival and preemptive transplantation may be beneficial in this cohort.
Author(s): Owen RV, Thompson ER, Tingle SJ, Ibrahim IK, Manas DM, White SA, Wilson CH
Publication type: Article
Publication status: Published
Journal: Transplantation
Year: 2021
Volume: 105
Issue: 4
Pages: 905-915
Print publication date: 01/04/2021
Online publication date: 28/05/2020
Acceptance date: 02/04/2018
ISSN (print): 0041-1337
ISSN (electronic): 1534-6080
Publisher: Lippincott, Williams & Wilkins
URL: https://doi.org/10.1097/TP.0000000000003334
DOI: 10.1097/TP.0000000000003334
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