*Purpose: Significant weight change is defined as unintentional weight gain of ≥ 7% of body weight or unintentional weight loss of > 5% in one year. Pancreas transplant alone (PTA) recipients could gain significant weight due to the liberalization of diet or lose significant weight due to the presence of gastroparesis or due to decrease sugar intake to prevent hypoglycemia unawareness. There is limited information about significant weight change and graft outcomes for PTA recipients.

*Methods: We analyzed PTA recipients transplanted at our center between 01/2005 and 07/2017 and had at least one year of functional graft.

*Results: There were a total of 105 PTA recipients who fulfilled our selection criteria. 55 (52%) had significant weight changes (28, 27% significant weight gain and 27, 26% significant weight loss). Comparing significant weight change (WC+) and no weight change (WC-), baseline characteristics were similar between the groups except, female were more common in WC+ 65% vs 40% (p=0.009). All except one patient in WC+ was on steroid for long term maintenance. At one year, WC+ group gained mean of 0.9 ± 11.6 % and WC- group gained 0.08 ± 3.2 % weight from time of transplant (p=0.63). Although, not significant, by 5 years WC gained 4.5 ± 14.1 % of the body weight compared to 0.7± 13.9% in WC- ( p=0.37). 7 patients in WC+ were admitted at least once with gastroparesis symptom within first year of transplant, of which 4 were in significant weight loss and 3 with significant weight gain, while 3 in WC- were admitted due to gastroparesis within first year. Among 17 patients with death censored (D-C) graft failure at last follow up, 8 had normal c-peptide, indicating development of post-transplant DM. Of these, 3 were in WC+ group, all with significant weight gain and 5 in WC-. There was no difference in uncensored or D-C graft survival when comparing WC+ and WC- . A similar pattern was seen when comparing clinically significant weight loss or weight gain with no weight change (Figure 1).

*Conclusions: Although more than 50% of patients had significant weight changes after PTA, weight change did not affect patient or graft survival.

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