Department of Surgery, Albert Einstein Hospital, Philadelphia, PA, USA.
Clin Transplant. 2012 May-Jun;26(3):E284-92. doi: 10.1111/j.1399-0012.2012.01649.x.
The effect of donor body mass index (BMI) and donor type on kidney transplant outcomes has not been well studied. Scientific Registry of Transplant Recipients data on recipients of deceased-donor kidneys between 1997 and 2010 were reviewed. Donors were categorized by DCD status (DCD, 6932; non-DCD, 90,158) and BMI groups at 5 kg/m(2) increments: 18.5-24.9, 25-29.9, 30-34.9, 35-39.9, 40-44.9, and ≥ 45 kg/m(2) . The primary outcome, death-censored graft survival (DCGS), was adjusted for donor, recipient, and transplant characteristics. Among recipients of non-DCD kidneys, donor BMI was not associated with DCGS. Among DCD recipients, donor BMI was not associated with DCGS for donor BMI categories < 45 kg/m(2) ; however, donor BMI ≥ 45 kg/m(2) was independently associated with DCGS compared to BMI of 20-24.9 kg/m(2) (adjusted hazard ratio, 1.84; 95% CI, 1.23, 2.74). The adjusted odds of delayed graft function (DGF) was greater for each level of BMI above reference for both DCD and non-DCD groups. There was no association of donor BMI with one-yr acute rejection for either type of donor. Although BMI is associated with DGF, long-term graft survival is not affected except in the combination of DCD with extreme donor BMI ≥ 45.
供体体重指数（BMI）和供体类型对肾移植结果的影响尚未得到很好的研究。回顾了 1997 年至 2010 年接受已故供体肾脏的受者的科学移植受者登记处数据。根据 DCD 状态（DCD，6932；非 DCD，90158）和 BMI 分组（每增加 5kg/m2）对供体进行分类：18.5-24.9、25-29.9、30-34.9、35-39.9、40-44.9 和 ≥ 45kg/m2。主要结局是死亡校正移植物存活率（DCGS），根据供体、受者和移植特征进行调整。在接受非 DCD 肾脏的受者中，供体 BMI 与 DCGS 无关。在 DCD 受者中，供体 BMI < 45kg/m2 与 DCGS 无关；然而，与 20-24.9kg/m2 的 BMI 相比，供体 BMI ≥ 45kg/m2 与 DCGS 独立相关（调整后的危险比，1.84；95%可信区间，1.23，2.74）。对于 DCD 和非 DCD 组，每个 BMI 水平高于参考值，延迟移植物功能（DGF）的调整后几率都更大。供体 BMI 与两种类型供体的 1 年急性排斥反应无关。虽然 BMI 与 DGF 相关，但除了 DCD 与极端供体 BMI ≥ 45 的组合外，长期移植物存活率不受影响。
