Outcomes of right lobe donors with BMI≥30 for living donor liver transplantation. Issue 7 (8th June 2022) - Andacoglu, Oya
Abstract: Background: Donor BMI above 30 is generally considered contraindication for donor hepatectomy. We compared the donor outcomes based on BMI threshold and weight loss. Patients and methods: All potential donors were identified and data were collected retrospectively. Steatosis was assessed based on liver‐spleen Hounsfield unit difference and absolute liver intensity values. We compared BMI≥30 ( n = 53) and BMI < 30 ( n = 64) donor outcomes. Donors with weight loss (WL) prior to surgery were also analyzed separately. Complications were graded by Clavien–Dindo classification. Results: All donors underwent open right donor hepatectomy. There was no difference between BMI≥30 and < 30 groups except female predominance in BMI≥30 group ( P = .006). Both groups had similar rates of complication rates in all categories, similar remnant volume, operative time, length of stay and similar postoperative liver function recovery (all P > .05). On the other hand, donors with WL were more commonly male, had smaller graft size, and higher biliary complications rates compared to no‐WL donors (all P < .05). Multivariate binary logistics regression analysis revealed no association between BMI or WL and outcomes. Conclusion: We demonstrate that donors with BMI≥30 have similar outcomes compared to BMI < 30 donors with our defined selection criterion, therefore BMI≥30 is not an absolute contraindication to donate right liver, provided that there is no significant steatosis and remnant liver is satisfactory. For potential overweight donors, WL down to BMI < 30 is a reasonable target. Higher biliary complication rates after WL should be investigated further.