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Author Topic: Living Kidney Donation, Obesity, and Dietary Change: Investing in Those Who Give  (Read 344 times)

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Offline Clark

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https://www.sciencedirect.com/science/article/pii/S1051227622000437

Living Kidney Donation, Obesity, and Dietary Change: Investing in Those Who Give the “Gift of Life”
Swee-Ling L. Levea MD Jaclyn L. Albin MD
https://doi.org/10.1053/j.jrn.2022.03.002

Introduction
The current United States waiting list for deceased kidney donors has 90,041 potential recipient candidates awaiting kidney transplantation.1 Waiting time for a deceased donor can be influenced by age, blood type, degree of sensitization, and time on dialysis, and it can vary from 3 years to as long as 10 years. The number of potential kidney recipients on this waiting list increases by the day, but the number of kidney transplants performed lags significantly behind. Despite the global COVID-19 pandemic, the United States had the highest number of kidney transplant surgeries performed in 2021, with 24,670 recipients and a record of 18,699 transplants from deceased donors.1 There remains a substantial gap between those in need of a transplant and the supply of organs.
Living kidney donation plays a critical role in timely transplantation and excellent outcomes for the recipients. Despite the growing number of waiting list patients and deceased donor transplants, the number of living kidney donations performed has plateaued. Since the early 2000s, living kidney donor (LKD) transplants have been static, ranging from 5,500 annually to 6,867 in 2019.1 The barrier to the expansion of the living donor pool is multifactorial and includes increasing incidence of medical complexities such as hypertension and obesity. While there are absolute contraindications to kidney donation, such as active malignancy, the donor acceptance criteria for other isolated medical abnormalities such as obesity can vary by transplant centers.
Obesity is a growing worldwide epidemic, and transplant centers report a parallel increase in the number of overweight and obese LKDs. Long-term outcomes remain uncertain for these patients. Lifestyle modifications such as dietary change and exercise are often recommended, but there are very few resources to address this recommendation specifically for LKDs. There is limited nutrition information available for LKDs to address the lifelong healthy living patterns that are vital to minimize the risk for the development of chronic medical conditions such as diabetes, hypertension, and chronic kidney disease.

Conclusion
Obesity is a fast-growing, global epidemic with a significant impact on both the health outcomes of the general population and the transplant community. LKDs are motivated, engaged, and dedicated individuals who selflessly give the gift of life to another. In return, our transplant community should equip these heroes with the knowledge and practical skills to optimize their own health through lifestyle change. Transplantation is the epitome of teamwork, and for LKDs, a similar multidisciplinary approach can be implemented with registered dietitians and physicians with nutrition expertise to enable patients to build lifelong foundations for healthy living.
Unrelated directed kidney donor in 2003, recipient and I both well.
580 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

 

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