BACKGROUND AND OBJECTIVE: The relationship between preimplantation biopsy and graft outcome in kidney transplantation from obese living donors has not been studied. We reviewed graft outcomes and histological evaluation of zero-time biopsy specimens in kidney transplantation from obese living donors.

METHODS: We retrospectively evaluated 764 consecutive recipients at our institute. The subjects in the recipient cohort were stratified according to donor body mass index (BMI) as follows: obese living donors (OLD: BMI ≥ 25 kg/m2) and non-obese living donors (NOLD: BMI < 25 kg/m2). Histological evaluation results of zero-time biopsy specimens, early posttransplantation outcomes, patient survival, and graft survival were compared. Histological changes in each evaluated component of the kidney tissue were scored from 0 to 3.

RESULTS: Of the 764 kidney transplantations, 104 were OLDs (mean BMI: 26.4 ± 1.4 kg/m2) and 660 were NOLDs (mean BMI: 21.6 ± 2.0 kg/m2). In the histological evaluations, the scores for hyalinosis and tubular atrophy, but not for glomeruli and connective tissue, in the OLDs were significantly higher than those in the NOLDs. No significant differences were found between the 2 groups regarding incidences of acute graft rejection and slow graft function. Although significant differences in histological score were observed in the zero-time biopsy specimens between the OLDs and NOLDs, no significant differences in graft survival rate were observed between the 2 groups (Figure 1).

CONCLUSIONS: In the zero-time biopsies, the kidneys from the OLDs had histological problems compared with those from the NOLDs. However, the long-term graft survival rate in the patients with OLDs was similar to that of the patients with NOLDs. These results may indicate the criteria for utilization of OLDs, which should be considered when determining the appropriate donor.

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