Is BMI a Justified Contraindication for Kidney Transplantation? Introduction OHSU’s Kidney Transplant Program has set a BMI >35 kg/m 2 as a relative contraindication.

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Is BMI a Justified Contraindication for Kidney Transplantation? Introduction OHSU’s Kidney Transplant Program has set a BMI >35 kg/m 2 as a relative contraindication for transplant. This pilot study investigated whether BMI is associated with differences in medical outcomes in kidney transplant patients during the first six months post transplant. Jamie Libera, BS 1 ; Abigail Marlow, BS 1 ; Noelle Pervere, BS 1 ; Maureen McCarthy, MPH, RD, LD, CSR 2 Oregon Health and Science University, 1 Graduate Programs in Human Nutrition- Dietetic Internship, 2 Food and Nutrition Services Methods A historical medical record review was used for a randomly selected subgroup of patients referred to Oregon Health and Science University (OHSU) for kidney transplant in Data was gathered via the OHSU EPIC medical record system through six months post transplant Associations between BMI and medical outcomes were analyzed Study Findings BMI was not associated with length of stay (Figure 1) BMI was not associated with change in creatinine from admission until discharge (Figure 2). The Cox proportional hazard model showed time to readmission was significantly associated with pre- transplant DM (Figure 3) and sex (Figure 4). No significant association was noted for age (p=0.66) or BMI (p=0.32) in risk for readmission. Overall, BMI does not appear to have a significant impact on post-transplant outcomes including post transplant diabetes mellitus (PTDM), and surgical complications in our sample population of 37 patients. Summary This pilot study demonstrated the relationship of BMI and kidney transplant outcomes. There were no associations between BMI and length of stay, creatinine changes, surgical complications, rate of infection, or readmission. Future Research Further more powered research on larger samples of OHSU kidney transplant patients is needed to solidify current BMI criteria. Figure 3. After controlling for age, sex and BMI, subjects with prior history of s meillitus (DM)had significantly (p=0.02) greater risk of readmission (estimated hazard ratio = 3.73; 95% CI: 1.2—11.2). Figure 4. After controlling for age, BMI and prior history of diabetes mellitus (DM), females had a greater risk of readmission (estimated hazard ratio = 3.22; 95% CI: 1.04—10.0) compared to males (p=0.04). Length of stay as a function of BMI Creatinine change at time of discharge as a function of BMI Acknowledgements: Special thank you to Mike Lasarev and Diane Stadler for their ongoing encouragement and support. Figure 1. Median length of stay was 7 days (IQR = 6—8 days). There was no association between length of stay and BMI ( r s = 0.086, p=0.61) Figure 2. Median creatinine level at time of discharge was estimated to be 77% (95% CI: 72—82%) lower than the median level at admission, but was not associated with BMI (p = 0.866) Sample Characteristics 368 patients were referred 68 patients had undergone transplantation by January patients were selected for this study No significant difference between BMI of men and women (p=0.29). Diabetes Mellitus and hypertension were the primary etiologies for end stage renal disease (ESRD). n = 37 MaleFemale Gender73% (n= 27)27% (n= 10) Age50.6 (+/- 15.5)37.9 (+/- 18.4) BMI28.2 (+/- 4.03)26.3 (+/- 6.14)