Is Obesity an Obstacle to Being A kidney Donor? Experiences from A High-Volume Center

Donor Obesity in Kidney Transplantation

Abstract

Background: Donor obesity is considered a relative contraindication to kidney donation by most transplant centers because of concerns about short-term and long-term morbidity and mortality. In this study, the impact of kidney donor body mass index (BMI)on perioperative and postoperative morbidity was investigated.
Material and Methods: We included all individuals (n= 170) who donated their kidneys for living kidney transplants performed at our hospital between November 2017 and October 2018. We divided kidney donors into four groups according to their BMI; normal (< 25 kg/m2), overweight (25 - 29.9 kg/m2), class I obesity (30 - 34.99 kg/m2), and class II obesity (> 35 kg/m2). We compared preoperative and postoperative blood pressure, estimated glomerular filtration rate (eGFR), and proteinuria values. p< 0.05 was considered statistically significant in all analyzes.
Results: 32.9% of the donors had normal weight, 31.7% were overweight, 28.8% had class I obesity, and 9.4% had class II obesity. The mean postoperative hospital stay was 2.2(2-4) days, and there was no difference between donors with and without obesity (p > 0.05). The only parameter negatively correlated with low eGFR at 12 months postoperatively was donor age (p= 0.024 and r= 0.290). There was no correlation between eGFR and BMI (p=0.125 and r=0.065). No difference was observed in donors’ blood pressure measurements after kidney donation. Postoperative proteinuria was positively correlated with BMI (p= 0.02, r= 0.296).
Conclusion: Donor candidates with obesity may be considered donors for patients with end-stage renal disease for whom there are no other suitable living kidney donors after a thorough perioperative evaluation.