Managing the Obese Living Kidney Donor

摘要

Purpose of Review In the context of the obesity epidemic, an increasing number of obese individuals present for evaluation as living kidney donor candidates. No standardization exists regarding their selection criteria, evaluation, nephrectomy technique, postdonation follow-up requirements, and predonation weight loss strategies. We review the surgical and long-term medical safety profiles of living kidney donation in obese individuals, address considerations in their evaluation and postdonation follow-up, and explore emerging strategies for predonation weight loss. Recent Findings Minimally invasive donor nephrectomy is overall safe in obese individuals, but potentially increases long-term risk of end-stage kidney disease and mortality. Vigilance is needed in the selection, informed consent, counseling, and postdonation follow-up of obese living donors. Lifestyle modification is often inadequate for predonation weight loss, while bariatric surgery is an emerging strategy requiring ongoing studies. Careful evaluation, surgical technique, and medical care can support safe living kidney donation in selected obese candidates.