Abstract: FR-PO1133
The Weight of Donation: Obesity and Living Kidney Donor Outcomes
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Mahbub, Hasan Mohammad, Detroit Medical Center, Detroit, Michigan, United States
- Ray, Madhab, Henry Ford Hospital, Detroit, Michigan, United States
- Oki, Rikako, Henry Ford Hospital, Detroit, Michigan, United States
- Srivastava, Yash, Henry Ford Hospital, Detroit, Michigan, United States
- Almokdad, Mohammad, Henry Ford Hospital, Detroit, Michigan, United States
- Callaghan, Matthew, Henry Ford Hospital, Detroit, Michigan, United States
- Boby, Niya, Henry Ford Hospital, Detroit, Michigan, United States
- Ravi, Akshaya, Henry Ford Hospital, Detroit, Michigan, United States
- Ashish, Abhigail, Henry Ford Hospital, Detroit, Michigan, United States
- Ansari, Rehan, Henry Ford Hospital, Detroit, Michigan, United States
- Shrivastava, Pritika, Henry Ford Hospital, Detroit, Michigan, United States
Background
Obesity is increasingly prevalent among living kidney donors and poses unique challenges to pre-donation evaluation and long-term renal surveillance.
Methods
This retrospective single-center study examined the impact of BMI on post-donation renal function over a period of 5 years (2020-2025). Demographic details, comorbidities, serial serum creatinine (Cr), and estimated glomerular filtration (eGFR) were recorded at baseline, 2 weeks, 6 months, and 1-year post-nephrectomy. A linear creatinine slope (mg/dL/week) was modeled per donor. Binary (BMI <25 vs. ≥25) and four-tier group comparisons were performed using t-tests and one-way ANOVA.
Results
Of the 180 living donors, mean age was 43.7 ± 12.0 years; 52% were female. Donors were predominantly White (145/180, 80.6%), with Black donors comprising 8.3% (n=15), Hispanic donors 5.6% (n=10), Asian donors 2.8% (n=5), and multiracial donors 2.2% (n=4). BMI was categorized as <25 kg/m2 (28.3%), 25–30 kg/m2 (42.8%), 31–35 kg/m2 (24.4%), and >35 kg/m2 (3.9%). Higher BMI was associated with significantly higher prevalence of hyperuricemia and metabolic syndrome (p=0.025, <0.001 respectively).
BMI Analysis: Pre-donation creatinine trended higher with increasing BMI, likely reflective of greater lean body mass. Post-donation eGFR decline (~30–35% at 2 weeks) and 1-year recovery were comparable across BMI groups. Creatinine slope did not differ significantly by BMI (p=0.41).
Race Analysis: Black donors had comparable pre-donation eGFR to White donors but showed significantly higher post-donation creatinine at 6 months (p=0.005) and 1 year (p=<0.001), with a steeper creatinine slope, in spite of adjustment for age and BMI.
Conclusion
Higher BMI is independently associated with greater comorbidity burden and modestly worse eGFR preservation through 6 months post-donation, with convergence by 1 year. Racial disparities in post-donation renal function, particularly among Black donors, warrant further investigation in prospective studies with longer follow-up.