Barlas Ilhami Soykan, Aydogdu Ibrahim, Sinangil Ayse, Ucar Zuhal Atan, Koc Yeney, Ecder Tevfik, Akin Emin Barıs
Department of Kidney and Pancreas Transplantation, Istanbul Bilim University Sisli Florence Nightingale Hospital, Istanbul, Turkey.
Department of Kidney Transplantation, Bezmialem Vakif University, Istanbul, Turkey.
Transplant Proc. 2019 Sep;51(7):2210-2214. doi: 10.1016/j.transproceed.2019.02.042. Epub 2019 Aug 1.
Living kidney donation from donors with a body mass index (BMI) over 30 can bring risks for the donor and the recipients. In this retrospective study, we evaluated the effect of a donor's obesity on a donor's long-term surveillance and the recipient outcomes.
We performed hand-assisted retroperitoneoscopic donor nephrectomy in 565 living kidney transplantations between February 2009 and December 2015. One hundred fifty-two donors (26.9%) had a BMI > 30 and were described as the obese group. Four hundred thirteen donors (73.1%) were described as the nonobese group and had a BMI < 30. Incision to kidney removal time, mean follow-up period, postoperative complications, weight gained after surgery, and serum creatinine level (postop day 1-end of follow-up) were recorded for the donors. Serum creatinine level (postop day 5-end of follow-up) and immediate function of transplanted kidney were recorded for the recipients.
The obese donors were older, and the female sex was dominant. Mean incision to kidney removal period was longer in the obese patients (P = .012). The mean follow-up period was 49.97 ± 28.40 months for the donors. There was no significant difference in donor kidney function between the groups. The incidence of herniation was significantly higher in the obese group (P = .021). There was no significant difference between the recipient early and late serum creatinine levels and slow and delayed graft functions after the transplantation.
Postoperative kidney functions concerning the outcomes of the obese and nonobese living donors were similar in our series. Donor BMI had no influence on early and late kidney functions of the recipients. There was no difference in postoperative complications, except incisional hernia, that was statistically more significant in the obese donors.
体重指数（BMI）超过30的活体肾供者会给供者和受者带来风险。在这项回顾性研究中，我们评估了供者肥胖对供者长期监测及受者结局的影响。
2009年2月至2015年12月期间，我们对565例活体肾移植受者进行了手辅助后腹腔镜供肾切除术。152例供者（26.9%）BMI>30，被归为肥胖组。413例供者（73.1%）BMI<30，被归为非肥胖组。记录供者的切口至取肾时间、平均随访期、术后并发症、术后体重增加情况以及血清肌酐水平（术后第1天至随访结束）。记录受者的血清肌酐水平（术后第5天至随访结束）及移植肾即刻功能。
肥胖供者年龄较大，且以女性为主。肥胖患者的平均切口至取肾时间较长（P=0.012）。供者的平均随访期为49.97±28.40个月。两组间供者肾功能无显著差异。肥胖组的疝发生率显著更高（P=0.021）。移植后受者早期和晚期血清肌酐水平以及移植肾功能缓慢和延迟方面无显著差异。
在我们的系列研究中，肥胖和非肥胖活体供者的术后肾功能结局相似。供者BMI对受者早期和晚期肾功能无影响。除切口疝外，术后并发症无差异，而切口疝在肥胖供者中在统计学上更显著。
