Clinical transplantation · 2026
Pretransplant Malnutrition Risk Components are Associated With Adverse Outcomes After Simultaneous Pancreas and Kidney and Solitary Pancreas Transplantation.
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Kennedy Katrina, Engelken Jessa, Rolfson Megan, Zhou Angela, Gibes Mina L, Salwa Najiyah, Mandelbrot Didier, Kaufman Dixon, Odorico Jon, Parajuli Sandesh
Аннотация
BACKGROUND: Malnutrition is common among patients with end-organ disease. The impact of any criterion of malnutrition (weight loss, muscle depletion, fat depletion, inadequate oral intake, or reduced functionality) pretransplant among simultaneous pancreas-kidney (SPK) or solitary pancreas transplant (SPT) recipients is understudied.
METHODS: In this single-center study, we included all SPK or SPT recipients who had pretransplant malnutrition assessed and were transplanted between 01/2016 and 04/2024. Recipients were categorized as at malnutrition risk (M+ve) if any one of the components of malnutrition was present and were compared with those without any component (M-ve). Outcomes of interest were length of stay, kidney delayed graft function (DGF), early readmission, cardiovascular events, acute rejection, uncensored graft failure, death-censored graft failure (DCGF), and death.
RESULTS: A total of 234 SPK and 136 SPT recipients fulfilled the selection criteria. 44 (19%) of SPK recipients and 13 (10%) of SPT were MR+ve, with reduced functionality being the most common positive malnutrition component in both groups. Among SPK recipients, after adjustment for multiple variables, MR+ve was associated with early readmission (aOR: 1.79; 95% CI: 1.08-2.97; p = 0.02). Similarly, among SPT, MR+ve was associated with early readmission (aOR: 6.15; 95% CI: 2.43-15.5; p < 0.001); pancreas uncensored graft failure (aOR: 3.3; 95% CI: 1.14-9.58; p = 0.03) and pancreas DCGF (aOR: 4.45; 95% CI: 1.44-13.67; p = 0.009).
CONCLUSION: The presence of any positive pretransplant malnutrition components is associated with worse posttransplant outcomes in pancreas transplant recipients. These findings help support informed decisions about transplant candidacy and nutrition optimization.
METHODS: In this single-center study, we included all SPK or SPT recipients who had pretransplant malnutrition assessed and were transplanted between 01/2016 and 04/2024. Recipients were categorized as at malnutrition risk (M+ve) if any one of the components of malnutrition was present and were compared with those without any component (M-ve). Outcomes of interest were length of stay, kidney delayed graft function (DGF), early readmission, cardiovascular events, acute rejection, uncensored graft failure, death-censored graft failure (DCGF), and death.
RESULTS: A total of 234 SPK and 136 SPT recipients fulfilled the selection criteria. 44 (19%) of SPK recipients and 13 (10%) of SPT were MR+ve, with reduced functionality being the most common positive malnutrition component in both groups. Among SPK recipients, after adjustment for multiple variables, MR+ve was associated with early readmission (aOR: 1.79; 95% CI: 1.08-2.97; p = 0.02). Similarly, among SPT, MR+ve was associated with early readmission (aOR: 6.15; 95% CI: 2.43-15.5; p < 0.001); pancreas uncensored graft failure (aOR: 3.3; 95% CI: 1.14-9.58; p = 0.03) and pancreas DCGF (aOR: 4.45; 95% CI: 1.44-13.67; p = 0.009).
CONCLUSION: The presence of any positive pretransplant malnutrition components is associated with worse posttransplant outcomes in pancreas transplant recipients. These findings help support informed decisions about transplant candidacy and nutrition optimization.