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Higher Body Mass Index Before Living Kidney Donation Can Increase Wound Infection after Hand-Assisted Laparoscopic Living Donor Nephrectomies

X. Benavides, M. Merzkani, R. T. Rogers, E. K. Tan, S. Thirunavukkarasu, B. H. Smith, A. D. Rule, M. Prieto, J. K. Heimbach, T. Taner, G. K. Chow, P. G. Dean, M. D. Stegall

Kidney Transplant, Mayo Clinic, Rochester, MN

Meeting: 2020 American Transplant Congress

Abstract number: B-029

Keywords: Donation, Infection, Surgical complications, Weight

Session Information

Session Name: Poster Session B: Kidney Living Donor: Other

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: According to the CDC (2015-2016), 71.6% of the adult population in the United States has a BMI equal or higher than 25kg/m2, and the living kidney donors are not exempt. This study aims to determine how the Body Mass Index (BMI) affects intraoperative and postoperative complications after hand-assisted laparoscopic living donor nephrectomies (HALLDN).

*Methods: We assessed complications of all HALLDNs (1/2000 to 7/2018) from surgery to discharge and per our center’s protocolized follow-up to 120 days. Baseline pre-donation characteristics were obtained at the moment of pre-donation evaluation. BMI was obtained one week before the HALLDN.

*Results: Of the 2837 HALLDNs, 2764 had research consent. The average age was 44.3 yrs. (18-77), 87.3% Caucasians, and 58.3% females. 35.9% had a history of abdominopelvic surgery, and 14.9% were current smokers. 1897 (68.6%) patients had a BMI > 25kg/m2. Among these donors, infraumbilical midline incision (1509, 79.5%) was more common compared to Pfannenstiel and paramedian incision. As seen in Table, the postoperative complications were 197 (10.4%, RR= 0.989 (0.782-1.251)), the need for readmission was 57 (3%, RR=0.651 (0.438-0.967)), and reoperation was 31 (1.6%, RR=0.83 (0.463-1.497)). There were more wound infections (56, 2.9%) in the donors with BMI≥ 25kg/m2 with RR= 2.3 (1.225-4.418) compared with the referent population. The Cochrane Armitage Trend expressed Z=2.24, (0.0127).

*Conclusions: Patients with a BMI ≥25kg/m2 have a 2.3-fold increase in having a wound infection after a HALLDN. Although higher BMI didn’t increase the overall complications, we consider that measurements should be taken to prevent wound infection after HALLDN.

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To cite this abstract in AMA style:

Benavides X, Merzkani M, Rogers RT, Tan EK, Thirunavukkarasu S, Smith BH, Rule AD, Prieto M, Heimbach JK, Taner T, Chow GK, Dean PG, Stegall MD. Higher Body Mass Index Before Living Kidney Donation Can Increase Wound Infection after Hand-Assisted Laparoscopic Living Donor Nephrectomies [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/higher-body-mass-index-before-living-kidney-donation-can-increase-wound-infection-after-hand-assisted-laparoscopic-living-donor-nephrectomies/. Accessed May 11, 2025.

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