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Abstract: SA-PO980

Perioperative Donor Nephrectomy Risks in Living Kidney Donors with Obesity: A Systematic Review and Meta-Analysis

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Al Ammary, Fawaz, University of California Irvine, Irvine, California, United States
  • Adeyemo, Simeon, University of California Irvine, Irvine, California, United States
  • Muzaale, Abimereki, Johns Hopkins University, Baltimore, Maryland, United States
  • Naveed, Asad, University of Toronto, Toronto, Ontario, Canada

Group or Team Name

  • Living Donor Transplant Outcome Collaborative (LDTOC).
Background

Obesity is a global public health concern. Given the shortage of living kidney donations, transplant centers have been more willing to accept obese donor candidates in recent years. To better counsel obese donor candidates about donor nephrectomy risks, we aimed to summarize evidence for the perioperative risks for obese living kidney donors compared to non-obese living kidney donors across studies.

Methods

A systematic search of standard databases was conducted to identify studies comparing obese and non-obese living kidney donors. Outcome data were extracted and synthesized. Obesity was defined as BMI ≥ 30. The risk of bias was assessed using Cochrane's risk of bias in non-randomized studies - of interventions (ROBINS-I) tool.

Results

Fifteen cohort studies were included in the final review. Obese patients have significantly longer operative times compared to non-obese patients, with a standardized mean difference of 0.93 (95% CI: 0.21 to 1.65, P=0.01), favoring non-obese donors (Figure 1). Additionally, Obese donors have significantly higher odds of surgical complications compared to non-obese patients, with an odds ratio of 1.22 (95% CI: 1.00 to 1.48, P=0.05), favoring non-obese patients (Figure 2).

Conclusion

Living kidney donors with obesity have increased risks of longer operating time and perioperative complications. These findings highlight the need for interventions to minimize perioperative risk for obese donors and tailored follow-up care to ensure best outcomes for this group of donors, who provide a vital source for living kidney donation.

Operative time

Surgical complications

Funding

  • NIDDK Support