title: Donor BMI >30 Is Not a Contraindication for Live Liver Donation.
abstract: The increased prevalence of obesity worldwide threatens the pool of living liver donors. Although the negative effects of graft steatosis on liver donation and transplantation are well known, the impact of obesity in the absence of hepatic steatosis on outcome of living donor liver transplantation (LDLT) is unknown. Consequently, we compared the outcome of LDLT using donors with BMI <30 versus donors with BMI ≥30. Between April 2000 and May 2014, 105 patients received a right-lobe liver graft from donors with BMI ≥30, whereas 364 recipients were transplanted with grafts from donors with BMI <30. Liver steatosis >10% was excluded in all donors with BMI >30 by imaging and liver biopsies. None of the donors had any other comorbidity. Donors with BMI <30 versus ≥30 had similar postoperative complication rates (Dindo-Clavien ≥3b: 2% vs. 3%; p = 0.71) and lengths of hospital stay (6 vs. 6 days; p = 0.13). Recipient graft function, assessed by posttransplant peak serum bilirubin and international normalized ratio was identical. Furthermore, no difference was observed in recipient complication rates (Dindo-Clavien ≥3b: 25% vs. 20%; p = 0.3) or lengths of hospital stay between groups. We concluded that donors with BMI ≥30, in the absence of graft steatosis, are not contraindicated for LDLT.
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.|General-, Visceral- and Transplantation Surgery, University Hospital of Frankfurt am Main, Frankfurt, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Knaak
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Goldaracena
authors.affiliation: Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Doyle
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: M S
authors.initials: MS
authors.lastname: Cattral
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: P D
authors.initials: PD
authors.lastname: Greig
authors.affiliation: Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Lilly
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: I D
authors.initials: ID
authors.lastname: McGilvray
authors.affiliation: Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: G A
authors.initials: GA
authors.lastname: Levy
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Ghanekar
authors.affiliation: Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: E L
authors.initials: EL
authors.lastname: Renner
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: D R
authors.identifier: 0000-0003-4468-8276
authors.initials: DR
authors.lastname: Grant
authors.affiliation: Department of Surgery, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Selzner
authors.affiliation: Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Selzner
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D018579:Patient Selection; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D009927:Tissue and Organ Procurement / Q000379:methods*
keywords: clinical research/practice; donors and donation: living; liver transplantation/hepatology; liver transplantation: living donor