TY - JOUR
T1 - Clinical Outcomes and Cardiometabolic Indices Post Kidney Transplant in Gastric Bypass Patients: A Propensity Score Matching Analysis.
AU - Salazar, M.
AU - Taber, D.
AU - Salas, M.
AU - Chavin, K.
AU - Bratton, C.
AU - Baliga, P.
AU - Srinivas, T.
PY - 2014/7/1
Y1 - 2014/7/1
N2 - Increasingly, morbidly obese kidney transplant (KTX) recipients undergo gastric bypass (GB) prior to transplant. We examine and compare the clinical and metabolic outcomes of post GB renal transplant recipients from patients with normal weight and morbidly obese. METHODS: A propensity score (PS) matching analysis compared 3 groups: normal control (NC; BMI 18-25 kg/m2), morbidly obese (MO) (BMI >35 kg/m2) and GB recipients. We matched groups 5:1:5 using binary logistic regression, nearest neighbor no caliper limits. Cohorts were matched for demographics (age, gender, race, diabetes, CV comorbidities), socioeconomics (insurance type, education level, income) and transplant factors (KDRI, donor type, PRA, HLA mismatches, cold time, warm time, induction therapy and DGF). The aim of the study was to assess clinical outcomes (rejection, infection, graft loss, death) and cardiometabolic indices (BP, lipids, DM). RESULTS: 176 KTX recipients were included; 16 GB patients were matched with 80 lean controls and 80 MO KTX recipients. PS matching produced similar cohorts for overall risk (table 1). Tacrolimus levels were similar across the first year and tending to be lower in the GB group after 1 year (p=0.103); MMF doses tended lower in the first month (p=0.172) and after year 1 (p=0.034) among GB. CMV was higher among MO but rejection and BK were similar across groups. In cardiometabolic comparisons, GB patients had improved BP (p
AB - Increasingly, morbidly obese kidney transplant (KTX) recipients undergo gastric bypass (GB) prior to transplant. We examine and compare the clinical and metabolic outcomes of post GB renal transplant recipients from patients with normal weight and morbidly obese. METHODS: A propensity score (PS) matching analysis compared 3 groups: normal control (NC; BMI 18-25 kg/m2), morbidly obese (MO) (BMI >35 kg/m2) and GB recipients. We matched groups 5:1:5 using binary logistic regression, nearest neighbor no caliper limits. Cohorts were matched for demographics (age, gender, race, diabetes, CV comorbidities), socioeconomics (insurance type, education level, income) and transplant factors (KDRI, donor type, PRA, HLA mismatches, cold time, warm time, induction therapy and DGF). The aim of the study was to assess clinical outcomes (rejection, infection, graft loss, death) and cardiometabolic indices (BP, lipids, DM). RESULTS: 176 KTX recipients were included; 16 GB patients were matched with 80 lean controls and 80 MO KTX recipients. PS matching produced similar cohorts for overall risk (table 1). Tacrolimus levels were similar across the first year and tending to be lower in the GB group after 1 year (p=0.103); MMF doses tended lower in the first month (p=0.172) and after year 1 (p=0.034) among GB. CMV was higher among MO but rejection and BK were similar across groups. In cardiometabolic comparisons, GB patients had improved BP (p
UR - http://Insights.ovid.com/crossref?an=00007890-201407151-00344
U2 - 10.1097/00007890-201407151-00344
DO - 10.1097/00007890-201407151-00344
M3 - Meeting abstract
VL - 98
SP - 111
JO - Transplantation
JF - Transplantation
ER -