Department of Surgery, Division of Transplantation, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama.
J Surg Res. 2019 Dec;244:50-56. doi: 10.1016/j.jss.2019.06.026. Epub 2019 Jul 3.
Living kidney donors (LKDs) with obesity have increased perioperative risks and risk of end-stage renal disease after donation. Consequently, obesity serves as a barrier to donation, as many transplant centers encourage or require weight loss before donation for obese LKD candidates. Therefore, this study sought to assess patients' perspectives on weight management strategies before donation among obese LKD candidates. We hypothesized that willingness to participate in a weight loss program may be associated with donor-recipient relationship.
Obese (BMI ≥30 kg/m) LKD candidates evaluated at a single institution from September 2017 to August 2018 were recruited. A survey was administered to assess LKD candidates' baseline exercise and dietary habits and their interest in weight management strategies for the purpose of donation approval. Participants were grouped by relationship to the recipient (close relatives: first-degree relatives or spouses [n = 29], compared with all other relationships [n = 21]). Descriptive statistics were used to summarize the data.
50 of 51 obese LKD candidates who were approached completed the survey. 90% of participants expressed willingness to lose weight if necessary to become eligible for donor nephrectomy. Compared with all other LKD candidates, close relatives were more likely to be interested in combined diet and exercise programs at our institution (P = 0.01).
Among obese LKD candidates, there was an interest in weight loss for the purposes of living kidney donation approval, particularly among close relatives of potential recipients. Future programs designed to promote weight management efforts for obese LKD candidates should be considered.
肥胖的活体供肾者（LKD）在围手术期和捐赠后发生终末期肾病的风险增加。因此，肥胖成为捐赠的障碍，因为许多移植中心鼓励或要求肥胖的 LKD 候选者在捐赠前减轻体重。因此，本研究旨在评估肥胖 LKD 候选者在捐赠前对体重管理策略的看法。我们假设，参与减肥计划的意愿可能与供受者关系有关。
从 2017 年 9 月到 2018 年 8 月，在一家机构评估了肥胖（BMI≥30kg/m）的 LKD 候选者。进行了一项调查，以评估 LKD 候选者的基线运动和饮食习惯，以及他们对捐赠批准目的的体重管理策略的兴趣。根据与受者的关系将参与者分为两组（近亲：一级亲属或配偶[n=29]，与所有其他关系[n=21]）。使用描述性统计来总结数据。
51 名被访的肥胖 LKD 候选者中，有 50 名完成了调查。90%的参与者表示，如果需要，他们愿意减肥以有资格进行供肾切除术。与所有其他 LKD 候选者相比，近亲更有可能对我们机构的联合饮食和运动计划感兴趣（P=0.01）。
在肥胖的 LKD 候选者中，有兴趣为了获得活体肾脏捐赠的批准而减轻体重，尤其是潜在受者的近亲。应考虑为肥胖的 LKD 候选者设计促进体重管理的计划。
