Introduction: Elderly as well as overweight/obese patients gradually increase in Renal Transplant (RT) waiting lists. Elderly patients are considered high-risk candidates.  RT in obese patients is known to prolong survival compared to remaining on dialysis, however, obesity is associated with worse functional outcomes. We sought to find if BMI categories correlate with different outcomes in our cohort of patients over the age of 65.

Methods: A retrospective study of 163 elderly patients who underwent RT between 01/01/2010-30/12/2016. Recipient and donor demographics were recorded, including 3-month and 12-month creatinine (Crea) and eGFR, delayed graft function (DGF), primary non-function (PNF), and 12-month patient (PS) and graft survival (GS). Data were re-grouped via the WHO BMI classification [Underweight (n=5), Ideal (n=56), Overweight (n=62), Obese Class I (n=30), Obese Class II (n=10), Obese Class III (n=0)]. 

Results: Significant differences favoured the Ideal BMI category for both median Crea and eGFR at 3-months: Ideal (128 µmol/L and 46 ml/min) vs Obese Class II (216 and 25) (p=0.005 and p=0.008, respectively), and at 12 months: Ideal (119.5 and 51) vs Overweight (160 and 38) (p=0.014 and p=0.022, respectively). No statistical differences occurred for DGF, PNF, PS, GS. In the Ideal category, in the interval from 3 to 12 months post-transplant, a statistically significant improvement was recorded in eGFR (46 vs 51, p=0.05). This phenomenon was also observed in the Obese Class II (25 vs 34.5, p=0.03), where Crea also improved significantly (216 vs 143.5, p=0.04).

Discussion: Our data indicate that even elderly patients with a BMI 25 – 39.9 can benefit satisfactory outcomes after RT. Obesity correlated with worse outcomes while Ideal BMI was associated with better functional outcomes at 3 and 12 months. No Obese Class III elderly patients were RT recipients. Awareness of the importance of weight loss prior to RT including available methods, is essential. Informed consent procedures for obese candidates should include the risk profiles associated with obesity and RT outcome.

[P074] Does Body Mass Index affect the functional outcomes of Renal Transplantation in elderly recipients?