ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

The Associations Between Body Mass Index and Kidney Transplant Outcomes Are Mediated by Weight-Adjusted Immunosuppression Dosing.

K. Flabouris,1,2 S. Chadban,1,3,4 M. Ladhani,1,3,5 M. Cervelli,6 P. Clayton.1,2,6

1Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia
2School of Medicine, University of Adelaide, Adelaide, Australia
3Sydney Medical School, University of Sydney, Sydney, Australia
4Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia
5Department of Renal Medicine, Lyell McEwin Hospital, Adelaide, Australia
6Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia

Meeting: 2017 American Transplant Congress

Abstract number: 356

Keywords: Dosage, Immunosuppression, Kidney transplantation, Obesity

Session Information

Session Name: Concurrent Session: Kidney: Cardiovascular and Metabolic

Session Type: Concurrent Session

Date: Monday, May 1, 2017

Session Time: 4:30pm-6:00pm

 Presentation Time: 5:18pm-5:30pm

Location: E451b

Purpose: High body mass index (BMI) is associated with acute rejection after kidney transplantation. We hypothesised that weight-adjusted immunosuppression dosing is a contributing factor. We therefore examined associations between BMI and acute rejection and infectious death, and whether immunosuppression dosing mediated these associations.

Methods: Using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry, we included all adult kidney-only transplant recipients over 2000-2014 (n=10,761). We used Cox models to examine associations between baseline BMI and: (1) time to acute rejection; (2) time to infectious death. We then modelled BMI and immunosuppression dosing as time-varying covariates in extended Cox models, including only patients treated with prednisolone, mycophenolate and a calcineurin inhibitor. Immunosuppression dosing was determined by grouping patients into quartiles of prednisolone dose/kg, mycophenolate dose/kg, and tacrolimus vs cyclosporin (binary covariate).

Results: Higher baseline BMI was associated with increased risk of acute rejection (adjusted hazard ratio (aHR)=1.14 per 5kg/m2 (95%CI 1.09-1.19), p<0.001). Baseline BMI was not significantly associated with infectious death. In time-varying analyses (n=7,919), higher BMI remained associated with rejection (aHR=1.16 (1.10-1.22), p<0.0001) but this association was attenuated after adjusting for immunosuppression dosing (aHR=1.08 (1.01-1.15), p=0.03). Higher time-varying BMI was associated with fewer infectious deaths (aHR=0.75 (0.65-0.86), p=0.0001) but not after adjusting for immunosuppression.

Conclusion: Higher BMI was associated with more acute rejection and fewer infectious deaths after kidney transplantation. Adjusting for weight-adjusted immunosuppression dosing attenuated these associations, suggesting that under-dosing of obese patients and over-dosing of underweight patients may mediate these associations. Dosing practices may require further examination in patients with abnormal BMI.

CITATION INFORMATION: Flabouris K, Chadban S, Ladhani M, Cervelli M, Clayton P. The Associations Between Body Mass Index and Kidney Transplant Outcomes Are Mediated by Weight-Adjusted Immunosuppression Dosing. Am J Transplant. 2017;17 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Flabouris K, Chadban S, Ladhani M, Cervelli M, Clayton P. The Associations Between Body Mass Index and Kidney Transplant Outcomes Are Mediated by Weight-Adjusted Immunosuppression Dosing. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/the-associations-between-body-mass-index-and-kidney-transplant-outcomes-are-mediated-by-weight-adjusted-immunosuppression-dosing/. Accessed May 8, 2025.

« Back to 2017 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences