Ann Liver Transplant.  2024 Nov;4(2):86-94. 10.52604/alt.24.0012.

Donor safety in living donors with a body mass index of ≥30 kg/m² : Experience of high-volume center in Asia

• Kim SM
• Yoon YI
• Moon DB
• Kim KH
• Ahn CS
• Ha TY
• Song GW
• Jung DH
• Park GC
• Hwang S
• Lee H

• KMID: 2561853
• DOI: http://doi.org/10.52604/alt.24.0012

Abstract

Background
As the prevalence of obesity and nonalcoholic fatty liver disease increases in recent years, the number of living donor liver transplantation from donor with high body mass index (BMI) is increasing. However, data on the effect of high BMI on outcomes in liver donors are lacking. This study aimed to investigate the influence of donor obesity (BMI ≥30 kg/m² ) on and clinical outcomes after donor right liver resection (DRLR).
Methods
Records of all living donors who underwent DRLR between January 2015 and December 2020 at Asan Medical Center were retrospectively reviewed. We divided donors into obese (BMI ≥30 kg/m² , n=41) and normal-weight (BMI ≤25 kg/m² , n=1,125) groups. To eliminate bias, matching was performed using the greedy method, and 34 donors involved in this study in each group.
Results
After matching, preoperatively, the obese group had significantly higher preoperative levels of serum aspartate aminotransferase (p=0.021), alanine aminotransferase (p=0.003), and a larger celiac artery depth ratio (p<0.001) and graft volume (p<0.001) than the normal-weight group. When comparing perioperative outcomes of donor, the operation time was longer in the obese group (p=0.019), but no difference was observed in postoperative major complication rates (p=0.314), lengths of hospital stay (p=0.607), and readmission rate (p>0.999). Furthermore, both groups had similar major surgical outcomes of recipients including biliary (p=0.163) complications and lengths of hospital stay (p=0.445).
Conclusion
DRLR may be safely performed in a select group of high BMI donors with ≥30 kg/m² without uncontrolled metabolic disease and significant liver steatosis in the absence of other suitable living donors.

Keyword

Liver transplantation; Living donors; Body mass index

Figure

• 

  Figure 1 Flowchart of the study design. LDRH, living donor right hepatectomy; BMI, body mass index; LDLT, living donor liver transplantation; MELD, model for end-stage liver disease.

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