Obesity, described as a body mass index (BMI) greater or equal to 30 kg/m2, is global epidemic. More than a third of the adults in the United States are considered obese. Organs from obese individuals are often not accepted for transplantation due to concerns of suboptimal organ quality and inferior allograft survival. This greatly affects the available pool of organs for transplantation. Several transplant centers reject pancreata from obese donors.
However, this practice may change because of a new study headed by Tarek Alhamad, MD, showing that pancreata and kidneys from mildly obese individuals are safe for transplantation. The study, published in Transplantation (Epub ahead of print) examined patients receiving simultaneous pancreas-kidney transplantation (SPKT). The impact of donor BMI (mildly obese 30-35 and very obese >35) on pancreas and kidney allograft survival was examined at 3 months and 1, 5 and 10 years post-transplantation.
“Historically, all outcome studies grouped all donors with BMI greater than 30 into 1 group and did not explore possible differences in the impact of mild obesity and severe obesity (BMI >35),” says Dr. Alhamad, who is an Assistant Professor of Medicine in Transplant Nephrology. “Our study shows that mildly obese donors (BMI 30 to 35) have similar outcomes to lean donors. Only donors with BMI>35 had worse outcomes.”
The authors stress that the results of this study do not replace the consideration of other donor risk factors, but serve as an encouragement not to decline organs solely on the status of a donor being mildly obese. “These finding may decrease the discard rate for pancreas,” says Alhamad.
There is a growing demand for pancreata for SPKT in patients with end-stage renal failure secondary to diabetes. Accepting organs from mildly obese donors will help increase the donor pool and decrease waiting times for transplantation.
The full article can be read here.