Winnicki E, et al. - In this retrospective cohort study using the Organ Procurement and Transplantation Network data from 2000 to 2013, researchers determined the impact of pre-transplant body mass index (BMI) on renal allograft function and survival in pediatric renal transplant recipients. Recipients categorized by BMI z-score were compared with respect to time to total allograft loss (allograft failure or death), prevalence of delayed graft function, prevalence of acute rejection, and estimated glomerular filtration rate (eGFR) post-transplant. Prevalence of obesity in these subjects was reported. An increased risk of allograft failure was observed in obese, but not overweight or underweight recipients. To achieve a better longevity of the renal allograft, it is important to implement effective obesity interventions in pediatric renal transplant recipients.