Purpose: Weight gain often coincides with aging. Post pancreas transplant, can allografts compensate to the added body mass?

Methods: We conducted a retrospective review of pancreas transplant at CUIMC from 1/1/08-11/1/22. All were >18 yo and underwent simultaneous kidney pancreas transplant, pancreas after kidney, or pancreas alone. Patients with <1yr graft survival were excluded. We compared recipient and donor factors of recipients with functional grafts (FF) vs those with post-transplant graft dysfunction (PTGD).

Results: 121 patients were included. BMI at evaluation 24.2±3.2kg/m2. 11.6% had T2DM. Pre-operative A1C was 8.2±1.7%. Donor age was 24.7±11yo with BMI 23.7±6kg/m2. 20 (17%) of recipients developed PTGD defined as an A1C>6.5% or need for diabetes medication. 50% of PTGD had BMI gain >5kg/m2 vs 25% FF (p=0.01). Most recent A1C 6.8±4% PTGD vs 5.3±3.5% FF (p<0.01). Donor age was higher in PTGD vs FF (29.6±10.5 vs 23.7±10.9 yo, p=0.03) On subanalysis of those who increased BMI >5kg/m2, donor age >30yo was associated with PTGD (p=0.03) (Fig 1). Comparing donor age >or<30yo, odds of PTGD with BMI gain was 12X with donors >30yo vs 1.2X with donors <30yo. Factors associated with BMI increase were age <40yo at transplant and BMI >25kg/m2 at evaluation.

Conclusions: When transplanting a patient <40yo with a BMI>25kg/m2, consider that they have an increased risk of weight gain after transplant and use a graft <30yo.


K.R.Mccune: None.

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