Evolution of body weight parameters up to 3 years after solid organ transplantation: The prospective Swiss Transplant Cohort Study

Abstract

Obesity and weight gain are serious concerns after solid organ transplantation (Tx); however, no unbiased comparison regarding body weight parameter evolution across organ groups has yet been performed. Using data from the prospective nationwide Swiss Transplant Cohort Study, we compared the evolution of weight parameters up to 3 years post-Tx in 1359 adult kidney (58.3%), liver (21.7%), lung (11.6%), and heart (8.4%) recipients transplanted between May 2008 and May 2012. Changes in mean weight and body mass index (BMI) category were compared to reference values from 6 months post-Tx. At 3 years post-Tx, compared to other organ groups, liver Tx recipients showed the greatest weight gain (mean 4.8±10.4 kg), 57.4% gained >5% body weight, and they had the highest incidence of obesity (38.1%). After 3 years, based on their BMI categories at 6 months, normal weight and obese liver Tx patients, as well as underweight kidney, lung and heart Tx patients had the highest weight gains. Judged against international Tx patient data, the majority of our Swiss Tx recipients' experienced lower post-Tx weight gain. However, our findings show weight gain pattern differences, both within and across organ Tx groups that call for preventive measures.

The impact of plasma brain‐derived neurotrophic factor concentration and weight gain after kidney transplantation

“…Kidney transplantation is the most common solid organ transplant procedure in the United States. We found that after kidney transplantation, patients had significant weight gain at 12 months, a finding which is consistent with our previous studies (Cashion et al, , 2007Stanfill et al, 2012) and the findings of others (Beckmann et al, 2017;Costa et al, 2014;Jezior et al, 2007). Significant weight gain in a short period of time after transplant increases the likelihood of surgical and medical complications, including organ rejection, and disqualifies recipients who may need a second transplantation (Heaphy et al, 2014).…”

The international prevalence and variability of nonadherence to the nonpharmacologic treatment regimen after heart transplantation: Findings from the cross‐sectional BRIGHT study

“…Most studies focusing on body mass index (BMI) at time of transplant have found an elevated risk for graft loss and mortality in HTx recipients with morbid obesity only (BMI > 35), but not in groups having a low BMI at transplantation . Still, many patients gain weight post‐HTx: one prospective registry study reporting overweight and obesity in, respectively, 37% and 13.6% of patients at 3 years after HTx, which might ultimately elevate the risk for chronic disease. Unfortunately, few dietary interventions have been tested in transplant patients, leaving ample room for new evidence on how to effectively support healthy eating in HTx recipients …”

Body Image in Liver Transplantation Recipients

“…Patients with lower BMI also had better BI than the overweight or obese patients, which is similar with findings in the general population. (55) Because liver transplant recipients are most likely to gain weight after transplantation compared with other transplant patients, (56) one can hypothesize that liver transplant patients may have more BI concerns compared with other organ recipients. Further studies are needed to test this hypothesis.…”