Lilli Schussler1, Prerna Khetan, MPH2, Edward Chin, MD2. 1Icahn School of Medicine at Mount Sinai, 2Mount Sinai
Introduction: To ensure safety in living donor nephrectomy, donor selection must be rigorous. Although reviews on evaluation of kidney donors have been published, there remains no established selection criteria [1]. To enlarge the donor pool, selection criteria for potential donors have become less strict, leading to a donor population with chronic conditions that are similar to those of the recipient pool and include obesity. We hypothesized that it is safe for obese patients to serve as living kidney donors.
Methods: In this single-center retrospective analysis, we examine the effects of obese BMI on creatinine in patients undergoing laparoscopic donor nephrectomy. Other outcomes include incidence of intraoperative and 30-day complications, including ileus. Analysis of data was performed using SAS 9.4. Distributions of continuous variables were assessed for normality using the Kolmogorov–Smirnov test. Normally distributed continuous variables were described using mean ± standard deviation, whereas continuous variables with distributions significantly deviating from normal were described using median (IQR). Continuous variables were compared using Student’s t-test for independent samples or the Mann–Whitney U test as appropriate. Categorical variables were described using frequency distributions and are presented as frequency (%). Categorical variables were compared by using Chi-square or Fisher’s exact test as necessary. All tests were two-tailed and considered significant at a p value lower than 0.05.
Results: Among obese and non-obese donors, no significant difference was observed in family history or history of prior intraabdominal surgery. There was no significant difference in 30-day morbidity between obese and non-obese donors (22.22% versus 15.79% respectively; p = 0.6388). At 6 and 12-month postoperative follow-up, the change in creatinine in obese patients was not significantly different from that of non-obese patients (+0.3592 in obese versus +0.3697; +0.3987 versus +0.3008 at 6 and 12 months, respectively).
Conclusion: There is no significant difference in the increase in creatinine level in obese versus non-obese patients after laparoscopic donor nephrectomy. These preliminary findings suggest that BMI greater than 30 is not related to decreased post-operative renal function. Laparoscopic donor nephrectomy is safe in obese patients.
[1] Davis CL, Delmonico FL. Living-donor kidney transplantation: A review of the current practices for the live donor. J Am Soc Nephrol 2005; 16: 2098–2110.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94152
Program Number: S150
Presentation Session: MIS Medley
Presentation Type: Podium