Abstract
IntroductionObese living donors who undergo donor nephrectomy have higher rates of intra-operative and post-operative complications. Many centres exclude obese donors from living donor transplant programs. Diet, exercise and medication are often ineffective weight loss interventions for donors, hence bariatric surgery should be considered.Case presentationWe report the case of a 53-year-old Caucasian woman who underwent laparoscopically adjustable gastric banding. The procedure enabled her to lose sufficient weight to gain eligibility for kidney donation. After losing weight, she had an uncomplicated laparoscopic donor nephrectomy surgery, and the recipient underwent successful kidney transplantation.ConclusionLaparoscopically adjustable gastric banding should be considered for obese potential living kidney donors whenever transplantation units restrict access to donor nephrectomy based on the increased surgical risk for donors.
Highlights
Obese living donors who undergo donor nephrectomy have higher rates of intra-operative and postoperative complications
Laparoscopically adjustable gastric banding should be considered for obese potential living kidney donors whenever transplantation units restrict access to donor nephrectomy based on the increased surgical risk for donors
Obese patients are categorized as high-risk and excluded from donor nephrectomy surgery by many centers even though equivalent mortality, non-wound related complications and recipient renal outcomes have been recorded across different body mass index (BMI) groups [3,4]
Summary
Obese living donors are often excluded from surgery because of the associated increased risk of local wound complications and blood loss [1,2]. Our patient's 53-year-old Caucasian wife whose blood group was O-positive was evaluated as a potential living unrelated kidney donor. Results of their T and B cell ALLO cross-matches were both negative. This equated to 21.5% loss in her original weight and an excess weight loss (calculated with a BMI of 25 kg/ m2 as the reference point) of 54%. Her most recent BMI is 33.5 kg/ m2
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