title: Obese Kidney Donors in the Laparoscopic Living Nephrectomy Era: How Safe?
abstract: BACKGROUND Obesity is a major worldwide health problem, causing up to 3.4 million deaths per year. It is considered to be a relative contraindication for laparoscopic surgery. Laparoscopic living donor nephrectomy is the criterion standard procedure for kidney procurement in many transplant centers. However, the selection of the obese donors undergoing laparoscopic nephrectomies is still debatable. The objective of this study was to compare short-term results of obese donors and non-obese donors undergoing laparoscopic living donor nephrectomies. MATERIAL AND METHODS A retrospective analysis of 259 live donors between November 2011 and August 2015 was performed. Body mass index equal to or more than 30 kg/m2 was categorized as obese. Twenty subjects were categorized as obese donors. We randomly assigned for 30 non-obese donors to the control group. Intra-operative and post-operative data were compared between these 2 groups. A p-value ≤0.05 was considered a significant difference. RESULTS Donor characteristics were the same in the 2 groups. No significant differences were found in the first warm ischemic time, estimated blood loss, or postoperative pain. The operative time in the obese group was significantly longer than in the control group (270 vs. 245 min, p≤0.05). The hospital stay was also significantly longer in the obese group (4 vs. 3 days, p≤0.05). CONCLUSIONS At our hospital, obese donors had short-term results comparable to those of non-obese donors in laparoscopic living nephrectomy. While longer operative time and length of stay were found, there were no significant complications observed. Long-term outcomes should be evaluated to justify use of obese donors.
authors.affiliation: Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Albertus
authors.initials: A
authors.lastname: Marcelino
authors.affiliation: Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Chaidir Arif
authors.initials: CA
authors.lastname: Mochtar
authors.affiliation: Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Irfan
authors.initials: I
authors.lastname: Wahyudi
authors.affiliation: Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Agus Rizal
authors.initials: AR
authors.lastname: Hamid
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D046148:Donor Selection; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D009765:Obesity / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012449:Safety; D020858:Tissue and Organ Harvesting; D055815:Young Adult