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Review
. 2022 Sep 23;16(2):254-261.
doi: 10.1093/ckj/sfac216. eCollection 2023 Feb.

Donor obesity and weight gain after transplantation: two still overlooked threats to long-term graft survival

Mehmet Kanbay  1 , Sidar Copur  2 , Duygu Ucku  2 , Carmine Zoccali  3   4
Affiliations
Review

Donor obesity and weight gain after transplantation: two still overlooked threats to long-term graft survival

Mehmet Kanbay et al. Clin Kidney J. .

Abstract

The effect of donor obesity on kidney transplantation success has long been an overlooked clinical research area. Even though there is no strict guideline in most countries prohibiting donation from obese individuals, most candidates with a body mass index >35-40 kg/m2 are rejected due to concerns regarding long-term renal functional deterioration in the donor. The effects of excessive fat mass on renal function and allograft survival have been analysed by several longitudinal and follow-up studies. These studies have documented the deleterious effect on long-term graft outcomes of excessive body mass in living kidney donors and de novo obesity or pre-existing obesity worsening after transplantation on kidney outcomes. However, there is a paucity of clinical trials aimed at countering overweight and obesity in living and deceased kidney donors and in transplant patients. In this review we will briefly discuss the mechanism whereby fat excess induces adverse kidney outcomes and describe the effects on graft function and survival in living obese donors.

Keywords: donor obesity; fatty kidney; graft survival; inflammation; kidney transplantation.

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Figures

Figure 1:
Figure 1:
The summary of hypothetical mechanisms behind the effect of donor obesity on the transplanted kidney and its consequences on the donor and recipient.
Figure 2:
Figure 2:
A cumulative graphic of three studies [28–30] illustrating the adjusted relationship between deceased donor BMI and death-censored graft failure/survival by multivariate analysis.
Figure 3:
Figure 3:
Potential therapeutic interventions to improve graft function during the post-transplantation period.
See this image and copyright information in PMC

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References

    1. Statista . Estimated number of worldwide kidney transplants in 2020, by region. https://www.statista.com/statistics/398657/kidney-transplants-by-world-r...(7 October 2022, date last accessed).
    1. Legendre C, Canaud G, Martinez F. Factors influencing long-term outcome after kidney transplantation. Transpl Int 2014;27:19–27. - PubMed
    1. Richie RE, Niblack GD, Johnson HKet al. . Factors influencing the outcome of kidney transplants. Ann Surg 1983;197:672–7. 10.1097/00000658-198306000-00005 - DOI - PMC - PubMed
    1. D'Agati VD, Chagnac A, de Vries APet al. . Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol 2016;12:453–71. 10.1038/nrneph.2016.75 - DOI - PubMed
    1. Brenner BM, Milford EL. Nephron underdosing: a programmed cause of chronic renal allograft failure. Am J Kidney Dis 1993;21:66–72. 10.1016/0272-6386(93)70097-I - DOI - PubMed