Introduction: Increased body weight in transplant patients has become a huge problem over the last years. Over the last decade only 52% of recipients and 58% of donors had a normal body mass index (BMI) at the time of transplant. While obesity is a clear risk factor for the recipient, there is contradictory information about the impact of abnormal donor weight on the outcome of a pancreas transplant. This issue may be especially of interest for the islet transplant community which prefers pancreata from overweight donors.

Methods: From 1/2002 to 12/2011 information of 5,583 US primary deceased donor SPK transplants with anti-T-cell induction and TAC and MMF maintenance immunosuppression was reported to the IPTR/UNOS registry. The recipients were in 35% overweight and in 12% obese. The donors for those transplants were in 30% overweight and in 8% obese. Univariate and multivariate calculations were performed to access the long-term impact of increased body weight on outcomes.

Results: The univariate analysis of outcome by recipient weight showed that being overweight or obese was a significant risk factor of patient survival (p=0.05), pancreas graft function (p<0.0001) and also for kidney graft function (p=0.02). Donor weight had the same univariate impact on patient survival (p=0.01), pancreas graft function (p=0.05) and kidney function (p=0.03). The difference in outcome between a normal and overweight recipients was not significantly different but between a normal and obese donors (p=0.01). A strong relationship between recipient weight and donor weight together with donor age could be found. The younger and lighter the donor the better was the outcome. The worst long-term outcome could be found in older obese donors.

Conclusions: While recipient weight is a known surgical risk factor, donor weight in combination with donor age showed a significant impact on long-term outcome in pancreas transplantation. The far best long-term outcomes could be found in donors with a normal body weight.

« Back to 2013 American Transplant Congress