The Impact of Donor Obesity on Outcomes after Cadaver Pancreas Transplants

We examined the impact of donor obesity on surgical complications and graft function after pancreas transplants. From January 1994 through December 2001, we performed 711 cadaver pancreas transplants. We analyzed outcomes for three groups based on donor body mass index (BMI): < 25 kg/m² (n = 434), 25-30 (n = 196), and > 30 (n = 81). Donor characteristics were similar between the three groups except for donor cause of death. Cerebrovascular deaths were more common in the BMI > 30 group (p = 0.002), while trauma deaths were more common in the BMI < 25 group (p = 0.02). In the BMI > 30 group, surgical complications, most notably surgical infections and thrombosis, were significantly more common; in addition, technical failure rates were higher and short-term graft survival was inferior. The incidence of technical failure was 9.7% in the BMI < 25 group, 16.3% in the BMI 25-30 group, and 21.0% in the BMI > 30 group (p = 0.04). However, when we looked at only technically successful transplants, we found minimal differences in the three groups with regard to graft survival at 1 and 3 years posttransplant. Donor obesity increased the incidence of surgical complications in our pancreas recipients, but did not affect initial graft function posttransplant. Technically successful transplants using obese donors results in good graft function at 1 and 3 years posttransplant.