Background: There has been a dramatic increase in obesity in the United States. Due to longer waiting times, utilization of kidneys from older donors has also increased. However, the impact of obesity in elderly donors on kidney transplant outcomes is not known.

Method: United Network for Organ Sharing Standard Transplant Research and Analysis data were analyzed and we evaluated 19,545 adult renal transplants from elderly donors ≥ 60 years between January 2000 and December 2016. Using a multivariable logistic regression model adjusted for recipient, donor, and transplant covariates, we examined the effect of BMI in elderly donors on 1-year death-censored graft loss (DCGL) and 1-year mortality.

Results: Elderly donor organs accounted for 7.8 % of all transplanted kidneys. Mean age of donors was 64±3.9 years and mean age of recipients was 60±11 years. Overall, 1-year DCGL was 7.3% and 1-year mortality was 6.7 %. In the adjusted analysis, donor BMI was not significantly related to 1-year DCGL. Similarly, donor BMI was not associated with worse patient survival for donor BMI categories < 40 kg/m²; however, donor BMI ≥ 40 kg/m² was independently associated with 1-year mortality compared to BMI of 18.5-24.9 kg/m² (OR, 1.5; 95% CI, 1.10-2.01, p<0.01).

Unadjusted patient survival was statistically significant between donor BMI ≥ 40 kg/m² and less groups (p<0.001).

Conclusion: BMI ≥ 40 kg/m² in elderly donors is associated with 50% increase in 1-year recipient mortality although no significant influence in 1-year DCGL. Additional investigations are needed to understand the cumulative impact of elderly donor obesity.

CITATION INFORMATION: Yamada M., Jandarov R., Kaur T., Shah S. Impact of Elderly Donor Obesity on Long-Term Outcomes in Renal Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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