Paper
Thursday, 20 July 2006
This presentation is part of : Chronic Care Initiatives
Weight Gain Following Kidney Transplantation: Impact of Donor Type on Weight Gain at One Year After Transplant
Michele Blakely, RN, MSN, CCTC1, Robert Stratta, MD2, Alan Farney, MD, PhD2, Michael Rohr, MD, PhD1, Aimee Sundberg, PharmD1, and Erica Hartmann, MD3. (1) Abdominal Organ Transplant Department, Wake Forest University Baptist Medical Center, Winston Salem, NC, USA, (2) Wake Forest Univeristy Baptist Medical Center, Winston Salem, NC, USA, (3) Wake Forest Unviersity Baptist Medical Center, Winston Salem, NC, USA
Learning Objective #1: Following this presentation the learner can define an expanded criteria kidney donor for organ transplantation.
Learning Objective #2: The learner will be able to discuss the relationship between weight gain and donor type in the kidney transplant recipient within the first post-transplant year.
Purpose: A major concern for the post kidney transplant patient is the connection between obesity and chronic conditions such as cardiovascular disease which is now the leading cause of death of kidney transplant patients. The purpose of this study was to assess whether expanded criteria donor (ECD) kidney transplant recipients gained less weight at 12 months post transplant when compared to standard criteria donor (SCD) transplant recipients. Expanded criteria donors are a predefined group of older (>50) deceased kidney donors that may have had hypertension, death from a cerebrovascular event, or elevated creatinine at the time of procurement. By definition they have lower nephron mass than standard criteria donors (SCD, defined as non-ECD). They are preferentially placed in lower body mass index (BMI) recipients (BMI<25) at our center. 

Methods: A retrospective, IRB approved study was performed on ECD (N=72), and SCD (N=98) adult kidney transplant recipients comparing the change in weight from baseline to 12 months post transplant. Body weights and BMI calculations (weight in kg/ height in m2) were obtained and compared at the time of transplant and 12 months post transplant.

Results: Weight gain between the ECD and SCD transplant recipients was not statistically significant at 12 months post-transplant. However, in the ECD group African American transplant recipients gained more weight (7.0 kg. vs. 2.2 kg, p<0.05) than the Caucasian recipients. Overall, African American transplant recipients gained an average of 6.3 kg in the first 12 months after transplant, while Caucasian recipients only gained 2.4 kg regardless of donor type.

Conclusion: While most kidney transplant recipients do gain weight post transplant there was not a significant difference in weight gain based on donor type. SCD recipients did not gain significantly more than an ECD recipient. However, African Americans tended to gain more weight in the first 12 months after transplant than did Caucasian recipients.

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