Obese living kidney donors: Short-term results and possible implications

Background Living kidney donation has increased recently as the shortage of cadaveric organs continues. This increase has occurred in part, due to exp anded donor criteria, including obese patients. This is a potential concern because obesity is associated with surgical complications, possibly death, and chronic medical problems. To address this concern, we examined the out come of a large group of obese (ObD) and nonobese living kidney donors (NOb D). Methods. A total of 107 obese (body mass index greater than or equal to 27 kg/m(2)) and 116 nonobese (body mass index<27 kg/m2) living kidney donors d onating at a single institution between 1990 and 1996 were studied. Surgica l complications, operative duration, and hospital length of stay were asses sed. Preoperative blood pressure, serum creatinine, creatinine clearance, p rotein excretion, fasting glucose, and hemoglobin A1C were measured and fir st degree relatives with diabetes were identified. Results. Overall complications were significantly more common in ObD, 16.8 vs, 3.4% (P=0.0012), The majority of complications in the entire cohort, 56 %, were wound related and were significantly more common in ObD (P=0.016), There was no significant increase in nonwound-related infections, bleeding, or cardiopulmonary events, There were no deaths or major complications. Op erative time was significantly longer in ObD 151+/-30 vs. 141+/-29 min (P<0 .05) but hospital duration was no different, Predonation, blood pressure in ObD was significantly higher, (P<0.05) and they more often had a family hi story of diabetes, 46 vs. 30% (P<0.05) than nonobese donors. Renal function , proteinuria, fasting glucose, or hemoglobin A1C were no different, Conclusion, With prudent selection, the use of obese living kidney donors a ppears safe in the short term. They experience more minor complications, us ually wound related, and slightly longer operations. Given a. higher baseli ne blood pressure and family history of diabetes, the long-term effect on t he remaining solitary kidney in ObD needs to be examined.