Safety of nephrectomy in morbidly obese donors

To satisfy donor organ shortage, overweight and obese donors are becoming a greater proportion of the kidney donor pool. Although good safety data exist in overweight and moderately obese individuals (body mass index = 25 to 35 kg/m²), there is little information about outcomes in morbidly obese donors (body mass index ≥ 40 kg/m²). The purpose of this study was to review the experience with morbidly obese donors in a single center and assist in the discussion about the feasibility of nephrectomy in such cases.

Outcomes of nephrectomy in morbidly obese donors between January 2005 and June 2010 were reviewed retrospectively and compared with outcomes in nonobese donors.

Of 386 nephrectomies, 7 involved morbidly obese donors. Mortality and major complication rates were low in all body mass index categories. A high incidence of minor postoperative complications was observed in the morbidly obese, with 57% morbidly obese patients requiring treatment for complications including respiratory infection, compared with 30% in nonobese donors (P < .05). There were no significant differences in mean operative time, estimated blood loss, and length of hospital stay between all body mass index categories. Limited follow-up data (mean, 20 mo) showed similar renal function parameters between groups.

The limited data suggest that nephrectomy may be feasible in selected morbidly obese donors. Further study is needed before major conclusions can be made.