Abstract

Background/Objectives: To determine the association between post-pancreas transplantation weight gain and graft dysfunction. Methods: Retrospective analysis of pancreas transplantation from 1 August 2008 to 1 November 2022. All patients > 18 years old who underwent simultaneous kidney pancreas transplant (SPK), pancreas after kidney transplant (PAK), and pancreas transplant alone (PTA) with at least one year of follow up were included. The association between post-transplant weight gain and graft dysfunction was assessed. Graft dysfunction was defined as HbA1c > 6.5% or use of antihyperglycemic medication. Results: Twenty-five percent of recipients had substantial weight gain (SWG), defined as >7% weight increase, by 1 year post-transplant. Recipients with T2D and SPK recipients were more likely to gain weight. SWG within the first year was significantly associated with the development of graft dysfunction at most recent follow up (Cox HR = 3.3, p = 0.005), but not at 1 year. Recipients with SWG in the first year had significantly higher HbA1C at most recent follow up (5.3 ± 0.7% vs. 5.9 ± 0.9%, p = 0.009), but not at 1 year. Among recipients with SWG occurring after 1 year, there were no differences in graft dysfunction or HbA1C at 1 year and no difference in graft dysfunction or HbA1C at most recent follow up. Conclusions: In this single-center study, SWG at 1 year post-transplant was associated with the development of graft dysfunction and elevated HbA1C in the long term.

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