Korean J Transplant.  2023 Nov;37(Suppl 1):S271. 10.4285/ATW2023.F-8812.

Impact of donor body mass index on the clinical outcomes after deceased donor kidney transplantation: a multicenter cohort

• Hong S
• Kim YS
• Han S
• Park WY
• Yang CW
• Jin K
• Chung BH

• KMID: 2551900
• DOI: http://doi.org/10.4285/ATW2023.F-8812

Abstract

Background
The aim of this study is to investigate the effect of body mass index of kidney transplant donor (KTD) on short and long-term clinical outcomes after deceased donor kidney transplantation (DDKT).
Methods
Among initial 873 patients, a total of 754 patients receiving DDKT between 2006 and 2021 among three multi-centers were included in the study. Patients were divided according to their kidney donors body mass index (BMI) into underweight (BMI, <18.5 kg/m²; n=41), normal weight (BMI, 18.5 kg/m² to < 25 kg/m²; n=496), and obese (BMI, ≥25 kg/m²; n=217) groups. Their clinicopathological characteristics, graft function, graft survival rates, donor kidney acute kidney injury (D-AKI), acute rejection (AR), and delayed graft function (DGF) were analyzed retrospectively.
Results
In obese donor group, the incidence of D-AKI was significantly higher in comparison with those in underweight or normal weight group. Furthermore, multivariate analysis showed that donor obesity was an independent prognostic factor for D-AKI development (odds ratio, 3.11; 95% confidence interval, 1.365–7.073; P=0.007). However, the prevalence of DGF and AR did not show meaningful difference among donor BMI groups. There was no significant association between donor BMI and 3-month to 3-year follow-up creatinine level (P=0.516) and also graft survival (P=0.619).
Conclusions
In this cohort study, we identified donor obesity is significant risk factor for donor kidney acute kidney injury. Though D-AKI is known risk factor for DGF, our results implies that donor BMI does not impact long-term allograft function and survival outcomes of DDKT. Therefore, utilization of obese donors kidney for transplantation could be considered positively.