*Purpose: We previously demonstrated a prevalence of food insecurity (FI) of 26.7% at our institution, in a pilot study of 45 pediatric kidney transplant (pedsKTx) patients. The impact of FI on pedsKTx outcomes is unknown. We report a single center cross-sectional descriptive study of transplant outcomes in FI and food secure (FS) pedsKTx patients.

*Methods: We expanded FI screening to all families in the pedsKTx clinic using the Hunger Vital Sign™. Sociodemographic and clinical characteristics were gathered from electronic health records at the time of screening November 2019 to November 2021. Outcomes included rejection episodes, hospital admissions, and infectious admissions. Characteristics and outcomes were statistically analyzed.

*Results: FI was identified in 19.5% (23/118) pedsKTx patients. FI patients were more likely to be on public insurance (FI 82.6% vs FS 51.6%; p= 0.007). There were no other demographic or transplant characteristics associated with FI (Table 1). There was no observed increased incidence of transplant rejections, hospital admissions or infectious admissions in patients with FI (Table 2).

*Conclusions: FI is common in pedsKTx particularly in recipients with public insurance. Although in our study we did not show an association between FI and adverse pedsKTx outcomes, an adequately powered study is warranted to identify the role of FI in pedsKTx outcomes.

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