The Impact of Pre-donation Weight Loss on Post-donation Outcome.
Dr. Marsden from Cardiff transplant unit, University of Wales, shared data on donor obesity from their living donor program during an abstract presentation at the ATC. Programs involved in clearing living kidney donors often have weight cutoffs for living kidney donors but the data on what happens to the weight post donation is unfortunately lacking. The result of a donor regaining the weight on other clinical parameters is also unknown.
In the study protocol donors were required to have a BMI ≤30 before kidney donation. Weight was assessed when the potential donor presented for donor evaluation, at donation, then 1 and 2 years post donation. The authors then divided 121 donors into 3 categories, where the median BMI was 26.8 and 25% of donors had a BMI >30. Donors with pre-assessment BMI >30 lost about 4.6% of their body weight resulting in a median weight change from 94.4 kgs at time of evaluation to 88.4 at the time of donation. Pretty impressive but unfortunately at the last follow up the median weight increased to 97 kgs—even higher than the pre-donation weight! Interestingly the amount of weight gain post donation was directly proportional to the degree of weight loss for kidney donation but not pre-assessment BMI. What’s even worse was that post donation weight gain correlated with systolic blood pressure and serum creatinine.
Many a doctor involved in clearing living donors worry about exactly this. Looks like there needs to be a sustained effort to help kidney donors keep weight off if we accept them for kidney donation after successful weight loss.
Post written by Dr. Vinay Nair, eAJKD Advisory Board member.
Check out all of eAJKD’s coverage of the 2013 American Transplant Congress.