T. A. Correya1, M. N. Mustian1, P. A. MacLennan1, B. A. Shelton1, R. D. Reed1, R. Grant1, B. Terry1, S. Smith1, M. Hanaway1, V. Kumar1, J. E. Locke1 1University Of Alabama at Birmingham,Birmingham, Alabama, USA
Introduction:
While the number of kidney transplant waitlist candidates is increasing, access to living kidney donation (LKD) is limited. Likewise, potential donors are becoming less healthy, with an increase in prevalence of isolated medical abnormalities, such as obesity. There is no general consensus in the transplant community regarding evaluation of obese potential donors, and the characteristics that affect their approval status for donation have not been well-described.
Methods:
A single-center retrospective case control study was performed, which analyzed all obese (BMI≥30 kg/m2) LKD candidates screened at our institution between 1/1/2012-12/31/2017. Of the 2423 obese candidates screened, 412 were evaluated in clinic, of which 33% were approved. Multivariable logistic regression was used to compare the potential donors who were approved for donation to their counterparts who were not approved.
Results:
There were no statistically significant differences between the two groups on the basis of age (p=0.59), gender (p=0.88), race (p=0.10), blood type (p=0.09), or family history of diabetes (p=0.66) or hypertension (p=0.42). However,LKD candidates who were approved for donation had a lower prevalence of metabolic syndrome (p<0.001), compared to those not approved. We also found that black race (aOR 0.51; 95% CI:0.31-0.85, p<0.01) increasing BMI (aOR 0.86; 95% CI:0.79-0.93, p<0.001), and metabolic syndrome (aOR 0.35; 95% CI:0.21-0.61, p<0.001) were associated with decreased odds of approval for donation.
Conclusion:
Among obese LKD candidates, metabolic syndrome was associated with significantly decreased odds of donation approval. Our findings suggest screening for metabolic syndrome in obese potential LKDs before clinic evaluation may reduce healthcare costs of LKD evaluations.
