Abstract: SA-OR076
Lost Opportunities for Living Donation: Is It Time for Weight-Loss Interventions for Motivated Potential Donors with High Body Mass Indices?
Session Information
- Transplantation: Clinical Controversies in Donation, Access, Monitoring, and Treatment
November 08, 2025 | Location: Room 370A, Convention Center
Abstract Time: 05:00 PM - 05:10 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Potter, Thomas B, Houston Methodist Academic Institute, Houston, Texas, United States
- Tumilty, Emma, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Al Awadhi, Solaf, Houston Methodist Academic Institute, Houston, Texas, United States
- Moore, Linda W., Houston Methodist Academic Institute, Houston, Texas, United States
- Gaber, Ahmed Osama, Houston Methodist Hospital, Houston, Texas, United States
- Waterman, Amy D., Houston Methodist Academic Institute, Houston, Texas, United States
Background
Many living donor candidates (LDC) are declined before evaluation due to obesity (BMI >34.9 kg/m2). Screening based solely on BMI may exclude individuals with otherwise healthy organs. This study examined how many potential donors were ruled out for BMI at a single center and the impact on their intended recipients' transplant outcomes.
Methods
A single-center retrospective review was conducted of LDCs who initiated donor screening using third-party software from 1/1/2017 to 12/31/2024. LDCs deemed ineligible due to obesity only—excluding duplicates, incomplete entries, or ineligibility post-evaluation—were matched to their intended recipients. Recipient electronic health records through 4/1/2025 were reviewed to determine days spent seeking transplant and whether they received a living donor kidney transplant (LDKT), a deceased donor kidney transplant (DDKT), remained listed, were removed from the waitlist, or died. Outcomes are reported as proportions and medians with interquartile ranges (IQRs)
Results
Of 12,105 potential donors, 1,298 (10.7%) were ruled out for obesity at initial screening. Donors excluded for BMI only were 80.2% female, had a median age of 38 years (IQR: 29,47), median BMI of 41.2 (IQR: 38.8,44.4), and varied by race/ethnicity (42.8% White, 23.6% Black, 31.1% Hispanic, 1.0% Asian, 1.3% Other). Of their 417 unique intended recipients, 96 (23.0%) underwent LDKT with another donor after waiting 558 days (IQR: 284, 973), and 41 (9.8%) underwent DDKT after 1228 days (IQR: 364, 1901; Figure). Eighty-three (20.0%) remain on the waitlist after 1287 days (IQR: 716,2086). Sixty-nine (16.5%) died or were removed due to poor health.
Conclusion
Excluding over 1,000 obese donors without weight loss options led to recipient deaths and delays; offering such programs could expand the donor pool and reduce waitlist risks.
Funding
- NIDDK Support