Purpose: In recent years, the increasing number of obese individuals in Japan has made transplant teams sometimes forced to select candidates with a high body mass index (BMI) as marginal donors in living donor liver transplantation. However, data are lacking regarding the impact of a high BMI on the outcome for liver donors, particularly over the long term. Here, we aimed to clarify the impact of a high BMI on postoperative short- and long-term outcomes in liver donors.
Methods: We selected 80 cases that had complete 5-year data available from hepatectomies performed in 2005 to 2015 in our institute. We divided donors into overweight (BMI ≥ 25 kg/m2, n = 16) and normal-weight (BMI < 25, n = 64) groups.
Results: Preoperatively, the overweight group had significantly higher preoperative levels of serum alanine aminotransferase and γ-glutamyl transpeptidase and a larger liver volume than the normal-weight group. Although the overweight group had significantly greater intraoperative blood loss (660 ± 455 vs 312 ± 268 mL, P = .0018) and longer operation times (463 ± 88 vs 386 ± 79 min, P = .0013), the groups showed similar frequencies of postoperative complications. At 1 year post hepatectomy, liver regeneration and spleen enlargement ratios did not significantly differ between the 2 groups. Remarkably, the overweight group showed significantly higher serum γ-glutamyl transpeptidase levels over the long term.
Conclusions: Overweight status alone was not a risk factor for either short- or long-term postoperative outcomes after a donor hepatectomy. However, donors with elevated γ-glutamyl transpeptidase levels, which was frequent among overweight donors, may require special attention.
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