title: Growth of a nation part I: impact of organ donor obesity on whole-organ pancreas transplantation.
abstract: Obesity has reached epidemic proportions in the USA. Consequently, there are an increasing number of potential organ donors that are obese, but would otherwise be appropriate donors for pancreas transplantation (PTx). This is a retrospective study of all PTx performed at Indiana University between 2003 and 2009 (n = 308) comparing donors with body mass index (BMI) <25, 25-29.9, and ≥30 kg/m(2) . Data included recipient and donor demographics, seven and 90-d graft loss, one-yr pancreas, kidney (for simultaneous pancreas and kidney transplant only) and patient survival, causes of graft loss and death, peak amylase and lipase, length of stay, readmissions, complications, HbA1C, and c-peptide. Of the 308 donors, 84 (27%) were overweight and 43 (14%) were obese. The overweight donors were significantly older, and the obese donors had hypertension significantly more frequently than the other two groups. There were no significant differences in recipient transplant demographics. There was no significant difference in length of stay or 90-d readmissions, seven or 90-d pancreas graft loss, one-yr graft or patient survival, peak serum amylase or lipase, HbA1C, or c-peptide. The incidence of post-transplant technical, immunological, and infectious complications were similar. Although technically challenging, PTx of allografts from obese donors can be accomplished with similar results compared to normal BMI donors.
authors.affiliation: Department of Surgery, Indiana University School of Medicine Indianapolis, IN, USA. jfridell@iupui.edu
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Fridell
authors.forename: Richard S
authors.initials: RS
authors.lastname: Mangus
authors.forename: Tim E
authors.initials: TE
authors.lastname: Taber
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Goble
authors.forename: Martin L
authors.initials: ML
authors.lastname: Milgrom
authors.forename: Jason
authors.initials: J
authors.lastname: Good
authors.forename: Ryan
authors.initials: R
authors.lastname: Vetor
authors.forename: John A
authors.initials: JA
authors.lastname: Powelson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000601:surgery*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous; D055815:Young Adult