Korean J Transplant.  2020 Dec;34(Supple 1):S52. 10.4285/ATW2020.OR-1264.

Changes in recipient body mass index for the first year after kidney transplantation are associated with intrapatient variability of tacrolimus concentration and long-term graft function

  • 1Department of Surgery, Seoul National University Hospital, Seoul, Korea


The aim of this study was to investigate the 5-year outcome of kidney transplant recipient according to the weight changes for the first year after kidney transplantation.
Data were retrospectively collected for 289 kidney transplant recipients between January 2012 and December 2014 in Seoul National University Hospital. Body mass index (BMI) was assessed at pre-transplant and before discharge, 1-month, 3-month, 6-month, and 12-month post-transplant. Intrapatient variability (IPV) was calculated as a coefficient of variation (CV), and outcome was evaluated as graft survival, estimated glomerular filtration rate (eGFR), and viral infection. The two groups according to the BMI changes during 1 year were divided as follows: group I (BMI change ≤–1.5 kg/㎡ or ≥+1.5 kg/㎡ ) and group II (–1.5 kg/㎡ < BMI change <+1.5 kg/㎡ ).
BMI declined to its lowest level at discharge (21.04±3.59 kg/㎡ ) and gradually increased to one year (22.38±3.18 kg/㎡ ). There was no significant correlation between IPV and BMI change (rho=0.19, P=0.757). However, the proportion of patients with high IPV (CV>25%) was higher in group I (P=0.008). There was no difference in graft survival between the two groups (P=0.646). The amount of change in eGFR (5-year eGFR to 1-year eGFR) tended to decrease to –3.29±25.65 mL/min/1.73 ㎡ (P=0.185) in group I, whereas it tended to slightly increase to 0.78±18.38 mL/min/1.73 ㎡ (P=0.583) in group II. However, there was no statistically significant difference between the two groups (P=0.154). There was no significant difference between the two groups in the incidence of viral infection (any virus, P=0.928; cytomegalovirus, P=0.830).
Our data demonstrated that recipients were more likely to have high IPV when the change in BMI was greater than ±1.5 kg/㎡ during 1 year after kidney transplantation. In addition, there was a tendency for the 5-year eGFR to decrease in those patients.

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