Introduction: The effect of obesity on kidney transplant outcomes has been incompletely characterised. We assessed the effect of recipient body mass index (BMI) on the outcomes of renal transplantation and the management of obese patients with end-stage renal disease (ESRD) across the UK.
Methods: We analyzed the data of 25539 adult renal transplants (men:61.8%, mean age:48.9 years, mean BMI:26.32) during 10 years (2007-2016) from the UK Transplant Registry. Patients were divided in BMI groups (underweight:<18.5, normal:18.5-24.9, overweight:25-29.9, class I obese:30-34.9, class II/III obese:≥35). Normal weight recipients were used as reference group. We also conducted a national survey of all UK renal transplant centers on the influence of BMI on decisions regarding management of potential renal transplant recipients. 
Results: BMI≥25 was an independent risk factor for delayed graft function and primary non-function (p≤0.001). Underweight (p=0.001), class I obese (p=0.017) and class II/III obese recipients (p<0.001) had poorer graft survival than normal BMI recipients, however, 5- and 10-year graft survival rates were very good. Patient survival was shorter for underweight recipients (p<0.001) and longer for overweight (p=0.028) and class I obese recipients (p=0.013). The national survey revealed significant variability among transplant centers in BMI threshold for listing patients on transplant waiting list and limited support with conservative or surgical procedures for weight control.
Conclusions: Obesity alone should not be a barrier for renal transplantation. Aa national strategy is required to give all patients equal chances in transplantation. Appropriate support with specialized teams in centers with significant experience and cooperation with bariatric surgeons could improve transplant outcomes.

[MP50] BMI INFLUENCE ON THE OUTCOMES OF RENAL TRANSPLANT