Short-term outcomes for obese live kidney donors and their recipients

Given the association between obesity and kidney disease, transplant professionals have debated the appropriateness of accepting obese live kidney donors. We hypothesized that compared with normal weight donors, donors with elevated body mass index (BMI) would have (1) more perioperative readmissions and reoperations and (2) a greater rise in blood pressure, greater percent rise in serum creatinine, and a greater loss of estimated glomerular filtration rate after nephrectomy.

Retrospective cohort study using Organ Procurement and Transplantation Network data on live donors who donated kidneys from July 1, 2004, to December 31, 2005.

Nine thousand three hundred nineteen live donor kidney transplants were performed. After eliminating donors with missing BMI data, 5304 donors were analyzed, among whom 2108 (40.0%) were overweight (25< or =BMI<30), 944 (17.8%) were obese (30< or =BMI<35), and 250 (4.7%) were very obese (BMI>=35). Readmission and reoperation rates did not differ across donor BMI categories. At baseline and at 6 months after nephrectomy, higher BMI was associated with higher blood pressure (P<0.01), but changes in systolic blood pressure from baseline were similar across BMI categories (P=0.40). At 6 months, decline in estimated glomerular filtration rate from baseline (P=0.63) and percent change in creatinine (P=0.11) did not differ significantly across groups. Delayed graft function was more common among recipients of kidneys from very obese donors (odds ratio 2.16, confidence interval 1.20-3.89, P=0.01), but the rates of recipient allograft failure and recipient mortality across donor BMI groups were similar.

Short-term follow-up data show good outcomes for donors with elevated BMI and their recipients.