*Purpose: Because donors for kidney transplantation are also aging in Japan, it is not uncommon that donors have metabolic syndrome (Met-S). It is necessary to examine the postoperative course of donors with Met-S and their impact for clinical course of recipients.

*Methods: Among the living kidney transplant donors performed at Ehime University after 2012, those who were followed up for more than 1 year were included. At the time of the first visit before the operation, we defined the following 4 conditions as the Met-S factor. 1) dyslipidemia (triglyceride 150 mg / dL or more and / or low-density lipoprotein (LDL) cholesterol 140 mg / dL or more) or under treatment, 2) hemoglobin A1c (HbA1c) 6.2% or more or under treatment, 3) umbilical level visceral fat area measured by computed tomographic (CT) volumetry is 100 cm² or more, and 4) taking 2 or more antihypertensive agents. Of these, 33 cases had 2 or more factors (group A), and other 30 cases did not have the Met-S factor (group B). We examined the impact of donor’s Met-S factor for clinical outcomes of kidney transplantation.

*Results: There was no significant difference in age in donor characteristics, but in group A, the number of males and body mass index (BMI) were significantly higher. The operation time of donor nephrectomy was significantly prolonged in group A. There was no significant difference in procured and residual renal volume, but arteriosclerosis of the renal arteries of procured kidney was significantly higher in group A. There was no difference between groups in the recipients’ characteristics. In group A, post-transplant renal biopsy showed significantly more glomerular sclerosis. Post-transplant rate of change compared with the pre-operative renal function in donor renal function was significantly inferior in group A after 1 and 5 years. In addition, post-transplant rate of change compared with the pre-operative renal function in transplanted renal function was significantly inferior in group A after 1 and 3 years.

*Conclusions: In renal transplantation of donors with Met-S factor, deterioration of renal function is observed in both donors and recipients, both donors and recipients need to obtain informed consent before transplantation for the expected postoperative course.

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