Outcome of living donor renal transplantation in obese recipients

The increasing prevalence of obesity among patients with end-stage renal disease accompanies more common renal transplantation from living donors. Since several studies have shown a negative impact of recipient obesity on renal transplantation outcomes, we investigated the influence of recipient-weight and donor-recipient-weight ratio on the outcome of living related renal transplantations. From October 2000 until December 2004, we performed 81 living donor renal transplantation with 30.8% (n = 25) of recipients with a body mass index >25 donor. In this group 6 patients lost their grafts (1-year survival rate, =76%). Among 56 recipients of normal body weight only 3 patients lost their graft (1-year graft survival rate, 94.6%; P < .001). Upon multivariate analysis body mass index was an independent risk factor for graft loss within the first year. When the body weights of the donor and recipient were analyzed in detail the quotient (body weight recipient(2)/ body weight donor) was also an independent risk factor. This study confirmed the results of larger analyses suggesting that body weight matching could significantly improve the outcomes in living donor renal transplantation. As a result of this study, in our institutional policy has changed; recipients of living donor grafts are only accepted when their body mass index is <25.