WTP2.7 Short and Long term Kidney Transplantation outcomes in Severely Obese Recipients. A UK NHSBT Transplant Registry Big Data Analysis over the last 20 years. An Epidemiology in Transplant Study Group (ETrSG) Initiative

Abstract Purpose Outcomes of renal-transplant-recipients with Class 3 obesity (severely obese) is extremely limited. An outcome-analysis of severely- obese transplant recipients reported to UK-NHSBT-Transplant-Registry was performed. Methods We harmonized the NHSBT-UK-Data to shortlist the renal-transplants performed on Class 3-obese recipients in the UK from 2000-2019. The demographics-report and survival-analysis at 1,3 and 5 years post-transplant were data-mined. Cox-Regression was done to identify predictors of survival. Results N=163 recipients with Class-3 obesity underwent renal-transplant since year 2000 (N=60 DBD, N= 48 DCD & N=55 Living Donor Kidney). The median-recipient-age was 47 years - DBD, 51 years DCD, and 43 years LRD transplants. The odds of females getting renal-transplants were OR 2.44(1.14- 5.19) p=0.01. Median-eGFR at 3 months was 40, 38, and 46.5 mL/min/1.73m2 for DBD, DCD, and LRD recipients, Median-eGFR at 12 months was 42, 46.5, and 51.5 mL/min/1.73m2 for DBD, DCD, and LRD recipients, respectively. The median-KDRI of transplanted kidneys was 1-07 and 1,08 for DBD & DCD kidneys, respectively. The commonest cause of graft-failure was acute-rejection within the first 12-months of transplant. The technical failure-rate was 1.8%. DCD-Grafts were more likely to suffer rejection (OR 2.25(1.13-3.89) p=0.002. The Graft-survival for DBD-kidneys was 97%, 92% and 89% at 1,3 & 5 years, The Graft-survival for DCD-kidneys was 89%, 86%, and 76% at 1,3 & 5 years, Graft-survival for LRD-kidneys was 98%, 95% and 86% at 1,3 & 5 years. (Log-Rank- 0.48). Conclusions Renal-Transplantation for severely-obese patients can be safely done with acceptable survival outcomes. Living donor kidneys have better results, but there is no statistical difference in graft-outcomes from DCD versus DBD-Kidneys.