Kidney Week

Abstract: TH-PO0996

Inflammatory and Morphologic Characteristics of Perinephric Adipose Tissue in Living Kidney Donors with Obesity: A Prospective Cohort Study

Session Information

• Transplantation: Basic - Immune Biology, Tissue Injury, and Emerging Technologies
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2001 Transplantation: Basic

Authors

• Tariq, Hira, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Hira Tariq, MBBS

• Tang, Hui, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Hui Tang

• Reiter, Jackie, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Jackie Reiter

• Lathiya, Maulik, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Maulik Lathiya, MBBS

• Denic, Aleksandar, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Aleksandar Denic, MD, PhD

• Kukla, Aleksandra, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Aleksandra Kukla, MD

Background

Living kidney donors (LKDs) with obesity are increasingly approved for kidney donation. BMI is a crude obesity measure and poor predictor of outcomes. In contrast, perinephric adipose tissue (PRAT) is linked to inflammation and fibrosis in animal models, but remains poorly characterized in otherwise healthy LKDs. We aimed to determine if LKDs exhibit a pro-inflammatory PRAT phenotype and PRAT thickness better predicts inflammation than BMI.

Methods

A prospective observational study enrolled LKDs (n=52) undergoing nephrectomy at Mayo Clinic, MN. Posterior and lateral PRAT thickness were measured on pre-donation CT angiograms of both kidneys. PRAT samples were collected intraoperatively. Adipocyte size was quantified from H&E sections using AI-based analysis. M1 (iNOS) and M2 (MRC1) polarization were assessed by immunofluorescence, and PRAT inflammatory gene expression by qPCR.

Results

Table 1 depicts demographic characteristics of LKDs with and without obesity. Obese LKDs had larger adipocytes area and a higher M1/M2 ratio indicating a pro-inflammatory phenotype. TGF-β1 and TNF-α expression was increased in obese donors. Higher obesity metrics were associated with lower anti-inflammatory M2 macrophages and higher TNF-α and TGF-β1 levels, while IL-6 was associated only with higher VAT and PRAT (Table 2).

Conclusion

Obese LKDs demonstrate early adipose inflammation, reflected by higher M1/M2 ratio and elevated inflammatory cytokines despite normal kidney function. PRAT area may be a more sensitive marker of early inflammatory changes than BMI.