American Journal of Kidney Diseases Association Between Weight Loss Before Deceased Donor Kidney Transplantation and Posttransplantation Outcomes  Meera Nair Harhay, Karthik Ranganna, Suzanne M. Boyle, Antonia M. Brown, Thalia Bajakian, Lissa B. Levin Mizrahi, Gary Xiao, Stephen Guy, Gregory Malat, Dorry L. Segev, David Reich, Mara McAdams-DeMarco  American Journal of Kidney Diseases  DOI: 10.1053/j.ajkd.2019.03.418 Copyright © 2019 National Kidney Foundation, Inc. Terms and Conditions

Figure 1 Box and whisker plots depict the distribution of absolute weight change (in kilograms) from listing to transplantation among deceased donor kidney transplant recipients in the United States by year. Black bars in the middle of white boxes indicate median values. Bottoms and tops of boxes represent interquartile ranges (IQRs), and tops and bottoms of whiskers represent values for weight change that extend from the boxes by no more than the IQR × 1.5. American Journal of Kidney Diseases DOI: (10.1053/j.ajkd.2019.03.418) Copyright © 2019 National Kidney Foundation, Inc. Terms and Conditions

Figure 2 Nonlinear associations between relative pretransplantation weight change and posttransplantation outcomes among US deceased donor kidney transplant recipients. Figure shows results of fractional polynomial methods to model the nonlinear unadjusted association of pretransplantation relative weight change, relative to no weight change, with (A) transplant hospitalization length of stay (LOS), (B) all-cause graft loss, and (C) posttransplantation mortality. Histograms in light gray display overall cohort distribution of pretransplantation relative weight change. Black lines indicates unadjusted estimates for each outcome of interest. Dark gray areas represent 95% confidence intervals (CIs). American Journal of Kidney Diseases DOI: (10.1053/j.ajkd.2019.03.418) Copyright © 2019 National Kidney Foundation, Inc. Terms and Conditions

Figure 3 Cumulative incidence curves for (A) all-cause graft loss and (B) mortality by relative pretransplantation weight change from listing to transplantation among US deceased donor kidney transplant recipients from 2004 to 2014. Log-rank P values for the contrasts between weight change categories were <0.001 for all-cause graft loss and posttransplantation mortality, respectively. At 5 years posttransplantation, all-cause graft loss occurred among 25% of recipients with <5% weight change and 5% to 9.9% weight gain, respectively, among 26% of recipients with 5% to 9.9% weight loss, among 27% of recipients with ≥10% weight gain, and among 28% of recipients with ≥10% weight loss. At 5 years posttransplantation, mortality occurred among 16% of recipients with weight gain of 5% to 9.9% and ≥10%, respectively; among 17% of recipients with <5% weight change and weight loss of 5% to 9.9%, respectively; and among 19% of recipients with weight loss ≥10%. American Journal of Kidney Diseases DOI: (10.1053/j.ajkd.2019.03.418) Copyright © 2019 National Kidney Foundation, Inc. Terms and Conditions