The Association between Body Composition Measurements and Surgical Complications after Living Kidney Donation.

Lisa B Westenberg,Cyril Moers,Robert A Pol,Camilo G Sotomayor,Marco Van Londen,Robert C Minnee,Stephan J L Bakker

doi:10.3390/jcm10010155

Abstract

Obesity is considered a risk factor for peri- and postoperative complications. Little is known about this risk in overweight living kidney donors. The aim of this study was to assess if anthropometric body measures and/or surgical determinants are associated with an increased incidence of peri- and postoperative complications after nephrectomy. We included 776 living kidney donors who donated between 2008 and 2018 at the University Medical Center Groningen. Prenephrectomy measures of body composition were body mass index (BMI), body surface area (BSA), waist circumference, weight, and waist–hip ratio. Incidence and severity of peri- and postoperative complications were assessed using the Comprehensive Complication Index. Mean donor age was 53 ± 11 years; 382 (49%) were male, and mean BMI at donor screening was 26.2 ± 3.41 kg/m2. In total, 77 donors (10%) experienced peri- and postoperative complications following donor nephrectomy. Male sex was significantly associated with fewer surgical complications (OR 0.59, 0.37–0.96 95%CI, p = 0.03) in binomial logistic regression analyses. Older age (OR: 1.03, 1.01–1.05 95%CI, p = 0.02) and a longer duration of surgery (OR: 1.01, 1.00–1.01 95%CI, p = 0.02) were significantly associated with more surgical complications in binomial logistic regression analyses. Multinomial logistic regression analyses did not identify any prenephrectomy measure of body composition associated with a higher risk of surgical complications. This study shows that higher prenephrectomy BMI and other anthropometric measures of body composition are not significantly associated with peri- and postoperative complications following living donor nephrectomy.

Highlights

Transplantation of kidneys from living donors has many advantages in comparison with transplantation of deceased donor grafts
Confronted with a changing living kidney donor pool due to the increasing prevalence of obesity worldwide [11] and the lack of a consensus on the threshold of body mass index (BMI) for living kidney donation acceptance criteria, the aim of this study is to assess whether BMI and other anthropometric body measures that are obtained in clinics are associated with an increased incidence of peri- and postoperative complications after nephrectomy
This study showed that in our cohort of living donors, there was no significant association between BMI or other anthropometric body measures and peri- and postoperative complications

Summary

Introduction

Transplantation of kidneys from living donors has many advantages in comparison with transplantation of deceased donor grafts. For patients with end-stage renal disease that undergo transplantation, patient and graft survival is better when transplanted with a graft from a living donor [1]. A BMI ≥ 35 kg/m2 has been associated with an increased risk of peri- and postoperative complications such as surgical site infection, deep venous thrombosis development, and incisional hernia [3,4,5]. Confronted with a changing living kidney donor pool due to the increasing prevalence of obesity worldwide [11] and the lack of a consensus on the threshold of BMI for living kidney donation acceptance criteria, the aim of this study is to assess whether BMI and other anthropometric body measures that are obtained in clinics are associated with an increased incidence of peri- and postoperative complications after nephrectomy

Objectives

Methods

Results

Conclusion