Weight Gain after Simultaneous Kidney and Pancreas Transplantation

BACKGROUND: Excessive weight (EW) gain is common after solid organ transplantation but there is little information concerning obesity after pancreas transplantation. The study goal was to characterize EW gain after kidney-pancreas (KP) transplantation.

METHODS: This was a retrospective single-center review of 100 KP recipients transplanted between September 2007 and June 2015.

RESULTS: The median percent weight gain for all recipients at one-year posttransplant was 10% (interquartile range [IQR] 2.7, 19.3%) of baseline weight. EW gain, defined as greater than or equal to a 19% one-year increase in weight, included all recipients (n=26) above the upper limit of IQR for weight gain at one-year. In multi-variate analysis, recipient age < 40 years, the use of tacrolimus/mTOR immunosuppression, and an acute rejection event were independent risk factors for EW gain. At a mean follow-up of 43±23 months, there was no difference in patient or graft survival between the EW and non-EW cohorts. Although mean HgbA1c levels between groups were equivalent, the EW versus non-EW cohort displayed a significant increase in mean insulin levels and a trend towards higher C-peptide levels. Criteria for posttransplant metabolic syndrome (PTMS) was met in 34.6% of EW versus17.6% of non-EW cohorts (p=0.07).

CONCLUSIONS: At intermediate-term follow-up, EW gain after KP transplantation was not associated with an increased risk of death or graft loss, although there was a trend toward a greater risk of PTMS. There may be a metabolic consequence of successful pancreas transplantation that results in EW gain in a proportion of recipients, leading to an increased risk of long-term cardiovascular complications.