Temporal Trends and Variation in BMI Thresholds for Living Donation Across the US.
1U Michigan, Ann Arbor
2Mayo Clinic, Rochester
3St. Louis U, St Louis
Meeting: 2017 American Transplant Congress
Abstract number: 409
Keywords: Donation, Kidney transplantation, Obesity
Session Information
Session Name: Concurrent Session: Evaluation Decisions: Living Kidney Donors
Session Type: Concurrent Session
Date: Tuesday, May 2, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:30pm-3:42pm
Location: E450b
The acceptable BMI threshold for living kidney donation is controversial. We examined the variability in center acceptance of living donors with high Body Mass Index (BMI) in the U.S. and simultaneously assessed temporal trends
Methods: Using data from OPTN we evaluated all living donors (LD) from 2001-2015 where the procuring and transplanting center was the same.We performed a multivariate hierarchal logistic regression model using pairwise comparison (Overweight:BMI 25-29.9, Mildly Obese: BMI:30-34.9 kg/m2 and Very Obese:BMI [sup3] 35 kg/m2 with Normal BMI:18-24.9 kg/m2) adjusting for donor age, race, gender,era (2001-2005; 2006-2010; 2011-2015) and center LD volume with clustering at center level. Metrics of heterogeneity (between centers) including intraclass correlation (ICC) and Median Odds Ratio (MOR) were calculated.
Results: 87,118 donors were identified. Proportion of “very obese” that underwent donor nephrectomy decreased from 5.0 % in 2001 to 2.6 % in 2015. Center effect explained only 0.3 % and 2 % of all variance for “overweight” and “mildly obese” patients respectively. However, 13% of the variance among the “very obese” was driven by center. MOR varied from 1.09 among “overweight” patients to 1.94 among “very obese”. Adjusted odds of LD nephrectomy by BMI group demonstrate a reduction in odds of accepting “very obese patients over time. (table)
| Adjusted Odds of undergoing LD nephrectomy | Era 2 (2006-2010) | Era 3 (2011-2015) | |
| Overweight | Ref | 1.031.071.12 | 1.101.151.20 |
| WHO Class 1 ( Mildly Obese) | Ref | 1.081.141.19 | 1.151.211.27 |
| WHO Class 2 and greater(Very Obese) | Ref | 0.590.650.71 | 0.480.530.59 |
Conclusion:There is a significantly reduced odds of using “very obese” living donors over the last 10 years. However the use of “overweight” and “mildly obese” living donors has increased.There exists a substantial variability by transplant centers in the use of “very obese” living donors. Further study should seek to define the short- and long-term outcomes of morbid obesity for living donors to inform evidence based and thus more consistent practices.
CITATION INFORMATION: Naik A, Cibrik D, Sakhuja A, Lentine K. Temporal Trends and Variation in BMI Thresholds for Living Donation Across the US. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Naik A, Cibrik D, Sakhuja A, Lentine K. Temporal Trends and Variation in BMI Thresholds for Living Donation Across the US. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/temporal-trends-and-variation-in-bmi-thresholds-for-living-donation-across-the-us/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress