Background. Living kidney donor (LD) eligibility criteria have expanded as a result of excellent donor outcomes and increasing organ demand. However, considerable variability exists between transplant centres for the acceptable pre-donation BMI. We investigated short and medium-term outcomes of LD according to BMI pre-donation.

Methods. We prospectively collected data on 579 consecutive LD in Imperial College Renal and Transplant Center during 2002-2015. Donors were stratified according to WHO-BMI (Kg/m²) classification as: Underweight (U=16-18.5), Normal (N=18.5-25), Overweight(O=25-30), Moderately Obese(MO=30-35) and Severely Obese(SO>35). We analysed data for kidney function [using Creatinine-Clearance(CrCl) and CKD-EPI], proteinuria(24h-urine protein) and Hypertension. Loss of GFR≥5ml/min/1.73m² per year was defined as progressive CKD.

Results. A total of 579 (334 female) donors were included. Full dataset was obtained for 549 donors. The number of patients per WHO category were: U=9(1.6%), N=178(32.4%), O=225(41%), MO=103(18.8%), SO=34(6.2%). CKD3 prevalence at the end of follow up was not different between donor groups based on CrCl (p=0.36). When CKDEPI-eGFR was utilized, there were more overweight and obese donors with CKD3 (p=0.04). There was no difference in progressive function deterioration between the two groups with CRCL (p=0.3), while obese donors had more progressive kidney function deterioration as per CKDEPI-eGFR (p=0.015). Moreover, there was no difference in proteinuria between the groups (p=0.7). Although overweight and obese donors were more likely to be hypertensive pre-donation (p=0.04), there was no significant difference in developing post donation hypertension between the groups (p=0.67).

Conclusion. Donor nephrectomy in the overweight and obese is not accompanied by more prevalent post-donation proteinuria or hypertension. However, we showed conflicting results regarding kidney function and progressive deterioration at the end of follow up, a finding which requires further investigation and raises questions regarding the most appropriate kidney function evaluation test post donation.

CITATION INFORMATION: Kousios A., Koutroutsos K., Charif R., Galliford J., Stubbs N., Dulku H., Orr H., Loucaidou M. Pre-Donation Body Mass Index Associations with Outcomes in Living Kidney Donors: A Single Centre Experience Am J Transplant. 2017;17 (suppl 3).

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