Selected Mildly Obese Donors Can Be Used Safely in Simultaneous Pancreas and Kidney Transplantation

    loading  Checking for direct PDF access through Ovid


BackgroundDonor obesity, defined as donor body mass index (D-BMI) of 30 kg/m2 or greater, has been associated with increased risk of technical failure and poor pancreas allograft outcomes. Many transplant centers establish a threshold of D-BMI of 30 kg/m2 to decline donor offers for pancreas transplantation. However, no previous studies differentiate the impact of mild (D-BMI, 30-35 kg/m2) versus severe obesity (D-BMI, ≥35 kg/m2) on pancreas allograft outcomes.MethodsWe examined Organ Procurement Transplant Network database records for 9916 simultaneous pancreas-kidney transplants (SPKT) performed between 2000 and 2013. We categorized donor body mass index (D-BMI) into 4 groups: 20 to 25 (n = 5724), 25 to 30 (n = 3303), 30 to 35 (n = 751), and 35 to 50 kg/m2 (n= 138). Associations of D-BMI with pancreas and kidney allograft failure were assessed by multivariate Cox regression adjusted for recipient, donor, and transplant factors.ResultsCompared with D-BMI 20 to 25 kg/m2, only D-BMI 35 to 50 kg/m2 was associated with significantly higher pancreas allograft [adjusted hazard ratio [aHR], 1.37; 95% confidence interval (CI], 1.04-1.79] and kidney allograft (aHR, 1.36; CI, 1.02-1.82) failure over the study period (13 years). Donor BMI 30 to 35 kg/m2 did not impact pancreas allograft (aHR, 0.99; CI, 0.86-1.37) or kidney allograft (aHR, 0.98; CI, 0.84-1.15) failure. Similar patterns were noted at 3 months, and 1, 5, and 10 years posttransplant.ConclusionsThese data support that pancreata from mildly obese donors (BMI, 30-35 kg/m2) can be safely used for transplantation, with comparable short-term and long-term outcomes as organs from lean donors. Consideration of pancreata from obese donors may decrease the pancreas discard rate.

    loading  Loading Related Articles