Conclusions
In this analysis of 22,360 adult patients undergoing isolated OHT, we
identified significant impacts of pretransplant weight changes on
posttransplant outcomes. Patients with ≥5% loss in weight from time of
OHT listing were found to have higher incidence of renal failure
requiring dialysis and drug-treated acute rejection at one year.
Furthermore, one-year survival was significantly reduced in comparison
to recipients with stable pretransplant weight, and the negative effects
of pretransplant weight loss are likely higher in patients with lower
initial waitlist BMI levels. This cohort represents a small (7.5%), but
high-risk subset of OHT recipients. As a result, efforts should be made
to identify these at-risk patients and focus on nutritional optimization
and weight loss prevention prior to OHT.