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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Recipient Minus Donor Body Mass Index Difference and One-Year Graft Function After Living-Donor Kidney Transplantation

  • Eren Eynel1
  • Idris Oruc1
  • Hasan Ince1
  • Enver Yuksel1
  • Ramazan Danis1
  1. 1Department of Nephrology, Gazi Yaşargil Training and Research Hospital, Diyarbakır 21070, Türkiye
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Abstract

Background: Recipient minus donor body mass index (BMI) difference is an anthropometric exposure whose anatomical validity is unproven. We evaluated its association with 1-year graft function after living-donor kidney transplantation. Methods: This retrospective cohort included all 249 adult living-donor kidney transplant recipients at one center during 2013–2024. Adjusted linear regression assessed 1-year estimated glomerular filtration rate (eGFR) among recipients alive with functioning grafts. The sensitivity, 6-month, longitudinal, ranked-composite, and clinical-event analyses were exploratory, without adjustment for multiple comparisons. Results: All 14 recipients without 1-year eGFR had experienced graft loss or death, leaving 235 for the primary analysis. The adjusted estimate was −0.55 mL/min/1.73 m2 per kg/m2 BMI difference (95% confidence interval [CI] −1.06 to −0.05; p = 0.033), equivalent to −2.77 (95% CI −5.31 to −0.23) per 5 kg/m2. Alternative BMI parameterizations showed similar fit. Exploratory eGFR estimates varied by visit and model specification. The unadjusted graft-loss/death hazard ratio was 0.88 per 5 kg/m2 (95% CI 0.55–1.42; 14 events). The full-cohort ranked-composite interval included zero. Conclusions: The adjusted eGFR association describes survivors with functioning grafts; complementary exploratory analyses do not change this conditional interpretation. Residual confounding remains possible. BMI difference does not quantify anatomical size mismatch, and these findings do not establish causality or donor-selection thresholds.

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Cite

BibTeXRIS
BibTeX
@article{eynel2026recipient,
  title = {{Recipient Minus Donor Body Mass Index Difference and One-Year Graft Function After Living-Donor Kidney Transplantation}},
  author = {Eren Eynel and Idris Oruc and Hasan Ince and Enver Yuksel and Ramazan Danis},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218298},
  url = {https://www.mdpi.com/2077-0383/15/21/8298},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Recipient Minus Donor Body Mass Index Difference and One-Year Graft Function After Living-Donor Kidney Transplantation
AU  - Eren Eynel
AU  - Idris Oruc
AU  - Hasan Ince
AU  - Enver Yuksel
AU  - Ramazan Danis
PY  - 2026
DA  - 2026/10/25
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218298
UR  - https://www.mdpi.com/2077-0383/15/21/8298
AB  - Background: Recipient minus donor body mass index (BMI) difference is an anthropometric exposure whose anatomical validity is unproven. We evaluated its association with 1-year graft function after living-donor kidney transplantation. Methods: This retrospective cohort included all 249 adult living-donor kidney transplant recipients at one center during 2013–2024. Adjusted linear regression assessed 1-year estimated glomerular filtration rate (eGFR) among recipients alive with functioning grafts. The sensitivity, 6-month, longitudinal, ranked-composite, and clinical-event analyses were exploratory, without adjustment for multiple comparisons. Results: All 14 recipients without 1-year eGFR had experienced graft loss or death, leaving 235 for the primary analysis. The adjusted estimate was −0.55 mL/min/1.73 m2 per kg/m2 BMI difference (95% confidence interval [CI] −1.06 to −0.05; p = 0.033), equivalent to −2.77 (95% CI −5.31 to −0.23) per 5 kg/m2. Alternative BMI parameterizations showed similar fit. Exploratory eGFR estimates varied by visit and model specification. The unadjusted graft-loss/death hazard ratio was 0.88 per 5 kg/m2 (95% CI 0.55–1.42; 14 events). The full-cohort ranked-composite interval included zero. Conclusions: The adjusted eGFR association describes survivors with functioning grafts; complementary exploratory analyses do not change this conditional interpretation. Residual confounding remains possible. BMI difference does not quantify anatomical size mismatch, and these findings do not establish causality or donor-selection thresholds.
SN  - 2077-0383
ER  -