Weight Gain and Acute Rejection in Patients Submitted to Pulmonary Transplantation: A Retrospective Cohort of 10 Years

Abstract

Objective. Acute rejection is one of the most common complications after pulmonary transplantation. The aim of this work was to verify the association of nutritional status and weight gain with acute rejection in the recipient during the 1st year after pulmonary transplantation. Methods. Retrospective cohort study with patients submitted to pulmonary transplantation at a pulmonary transplantation center in the state of Sao Paulo. Data on sex, age, underlying disease, type of transplantation, and presence, degree, and frequency of rejection according to the transbronchial biopsy results were collected, along with body mass index (BMI) and weight variation over the course of 1 year. The difference between groups was analyzed by means of Student t test and the association by means of chi-square test. Significance was considered with P < .05. Results. A total of 117 patients were included, of which 71 (60.7%) were male. The average age was 39.8 +/- 15.5 years. There were 77.8% with acute rejection in the 1st year after transplantation. The nutritional status of eutrophy prevailed according to BMI in both adolescents and adults, with no association with acute rejection (P = .80), and there was a greater weight gain among the individuals who showed rejection, with an increase of 7.58 kg (95% confidence interval [CI] 6.35-8.81) compared with those who did not present rejection, whose average weight gain was 4.12 kg (95% CI 1.28-6.95; P = .01). Conclusions. Nutritional status was not associated with acute cell rejection in the 1st year after transplantation, although weight gain was greater in those who had rejection.