{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T08:45:35Z","timestamp":1783413935749,"version":"3.54.6"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Obesity is considered a risk factor for peri- and postoperative complications. Little is known about this risk in overweight living kidney donors. The aim of this study was to assess if anthropometric body measures and\/or surgical determinants are associated with an increased incidence of peri- and postoperative complications after nephrectomy. We included 776 living kidney donors who donated between 2008 and 2018 at the University Medical Center Groningen. Prenephrectomy measures of body composition were body mass index (BMI), body surface area (BSA), waist circumference, weight, and waist\u2013hip ratio. Incidence and severity of peri- and postoperative complications were assessed using the Comprehensive Complication Index. Mean donor age was 53 \u00b1 11 years; 382 (49%) were male, and mean BMI at donor screening was 26.2 \u00b1 3.41 kg\/m2. In total, 77 donors (10%) experienced peri- and postoperative complications following donor nephrectomy. Male sex was significantly associated with fewer surgical complications (OR 0.59, 0.37\u20130.96 95%CI, p = 0.03) in binomial logistic regression analyses. Older age (OR: 1.03, 1.01\u20131.05 95%CI, p = 0.02) and a longer duration of surgery (OR: 1.01, 1.00\u20131.01 95%CI, p = 0.02) were significantly associated with more surgical complications in binomial logistic regression analyses. Multinomial logistic regression analyses did not identify any prenephrectomy measure of body composition associated with a higher risk of surgical complications. This study shows that higher prenephrectomy BMI and other anthropometric measures of body composition are not significantly associated with peri- and postoperative complications following living donor nephrectomy.<\/jats:p>","DOI":"10.3390\/jcm10010155","type":"journal-article","created":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T10:35:12Z","timestamp":1609842912000},"page":"155","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Association between Body Composition Measurements and Surgical Complications after Living Kidney Donation"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6438-3587","authenticated-orcid":false,"given":"Lisa B.","family":"Westenberg","sequence":"first","affiliation":[{"name":"Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"van Londen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6835-6386","authenticated-orcid":false,"given":"Camilo G.","family":"Sotomayor","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8014-8387","authenticated-orcid":false,"given":"Cyril","family":"Moers","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9494-3717","authenticated-orcid":false,"given":"Robert C.","family":"Minnee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus University Medical Center, Erasmus University Rotterdam, 3015 CN Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3356-6791","authenticated-orcid":false,"given":"Stephan J. L.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2236-5233","authenticated-orcid":false,"given":"Robert A.","family":"Pol","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1111\/j.1600-6143.2010.03022.x","article-title":"Kidney and Pancreas Transplantation in the United States, 1999-2008: The Changing Face of Living Donation","volume":"10","author":"Axelrod","year":"2010","journal-title":"Am. J. Transplant."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/ajt.14557","article-title":"OPTN\/SRTR 2016 Annual Data Report: Kidney","volume":"18","author":"Hart","year":"2018","journal-title":"Am. J. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Tjeertes, E., Hoeks, S., Beks, S., Valentijn, T., Hoofwijk, A., and Stolker, R. (2015). Obesity\u2014A Risk Factor for Postoperative Complications in General Surgery?. BMC Anesthesiol., 15.","DOI":"10.1186\/s12871-015-0096-7"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/joim.12299","article-title":"Obesity as a causal risk factor for deep venous thrombosis: A Mendelian randomization study","volume":"277","author":"Klovaite","year":"2014","journal-title":"J. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1159\/000365707","article-title":"Impact of Obesity on Complications of Laparoscopic Simple or Radical Nephrectomy","volume":"8","author":"Arfi","year":"2014","journal-title":"Curr. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1146\/annurev.med.49.1.215","article-title":"Surgical implications of obesity","volume":"49","author":"Flancbaum","year":"1998","journal-title":"Ann. Rev. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1111\/j.1600-6143.2007.01932.x","article-title":"The Medical Evaluation of Living Kidney Donors: A Survey of US Transplant Centers","volume":"7","author":"Mandelbrot","year":"2007","journal-title":"Am. J. Transplant."},{"key":"ref_8","unstructured":"Landelijk Overleg Niertransplantatie, and van der Heide, J.H. (2008). Nederlandse Richtlijn: Evaluatie Van Potenti\u00eble Donoren Voor Levende Donor Niertransplantatie, NTV."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1111\/j.1600-6143.2005.00791.x","article-title":"Obesity in Living Kidney Donors: Clinical Characteristics and Outcomes in the Era of Laparoscopic Donor Nephrectomy","volume":"5","author":"Heimbach","year":"2005","journal-title":"Am. J. Transplant."},{"key":"ref_10","first-page":"172","article-title":"High BMI and male sex as risk factor for increased short-term renal impairment in living kidney donors\u2014Retrospective analysis of 289 consecutive cases","volume":"46","author":"Unger","year":"2017","journal-title":"IJS"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/j.1600-6143.2012.04321.x","article-title":"Demographic, Metabolic, and Blood Pressure Characteristics of Living Kidney Donors Spanning Five Decades","volume":"13","author":"Taler","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1002\/bjs.11127","article-title":"Chronic pain after hand-assisted laparoscopic donor nephrectomy","volume":"106","author":"Zorgdrager","year":"2019","journal-title":"BJS"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e024502","DOI":"10.1136\/bmjopen-2018-024502","article-title":"Rationale and design of TransplantLines: A prospective cohort study and biobank of solid organ transplant recipients","volume":"8","author":"Eisenga","year":"2018","journal-title":"BMJ Open"},{"key":"ref_14","first-page":"303","article-title":"A formula to estimate the approximate surface area if height and weight be known","volume":"5","year":"1989","journal-title":"Nutrition"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/SLA.0b013e318296c732","article-title":"The Comprehensive Complication Index","volume":"258","author":"Slankamenac","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of Surgical Complications","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"192","DOI":"10.7182\/pit2014240","article-title":"Risk factors for perioperative complications in hand-assisted laparoscopic donor nephrectomy","volume":"24","author":"Alberts","year":"2014","journal-title":"Prog. Transplant."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/TP.0b013e3181643ce8","article-title":"Minimizing Morbidity of Organ Donation: Analysis of Factors for Perioperative Complications After Living-Donor Nephrectomy in the United States","volume":"85","author":"Patel","year":"2008","journal-title":"Transplantation"},{"key":"ref_19","first-page":"27","article-title":"Peritoneal adhesions. Incidence, cause, and prevention","volume":"24","author":"Menzies","year":"1992","journal-title":"Surg. Annu."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"\u00d6zdemir-van Brunschot, D.M., Koning, G.G., van Laarhoven, K.C., Erg\u00fcn, M., van Horne, S.B., Rovers, M.M., and Warl\u00e9, M.C. (2015). A comparison of technique modifications in laparoscopic donor nephrectomy: A systematic review and meta-analysis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0121131"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/ags3.12049","article-title":"Obesity as a surgical risk factor","volume":"2","author":"Ri","year":"2017","journal-title":"Ann. Gastroenterol. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3531","DOI":"10.1007\/s00464-011-1753-7","article-title":"Operation time and body mass index are significant risk factors for surgical site infection in laparoscopic sigmoid resection: A multicenter study","volume":"25","author":"Kurmann","year":"2011","journal-title":"Surg. Endosc."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"STARSurg Collaborative, Bhangu, A., Drake, T., and Nepogodiev, D. (2016). Multicentre prospective cohort study of body mass index and postoperative complications following gastrointestinal surgery. BJS, 103, 1157\u20131172.","DOI":"10.1002\/bjs.10203"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1089\/end.2006.20.794","article-title":"Obesity as a Risk Factor for Complications During Laparoscopic Surgery for Renal Cancer: Multivariate Analysis","volume":"20","author":"Kurzer","year":"2006","journal-title":"J. Endourol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1016\/j.transproceed.2019.02.042","article-title":"Hand-Assisted Nephrectomy Predisposes Incisional Herniation in Obese Living Donors","volume":"51","author":"Barlas","year":"2019","journal-title":"Transplant. Proc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/ajcn\/79.3.379","article-title":"Waist circumference and not body mass index explains obesity-related health risk","volume":"79","author":"Janssen","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1001\/jama.280.21.1843","article-title":"Abdominal Adiposity and Coronary Heart Disease in Women","volume":"280","author":"Rexrode","year":"1998","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12882-016-0386-4","article-title":"Central obesity associates with renal hyperfiltration in the non-diabetic general population: A cross-sectional study","volume":"17","author":"Stefansson","year":"2016","journal-title":"BMC Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jss.2018.03.022","article-title":"Prolonged operative duration is associated with complications: A systematic review and meta-analysis","volume":"229","author":"Cheng","year":"2018","journal-title":"J. Sur. Res."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Korol, E., Johnston, K., Waser, N., Sifakis, F., Jafri, H.S., Lo, M., and Kyaw, M.H. (2013). A Systematic Review of Risk Factors Associated with Surgical Site Infections among Surgical Patients. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0083743"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.jamcollsurg.2008.08.018","article-title":"Surgical Site Infection Prevention: The Importance of Operative Duration and Blood Transfusion\u2014Results of the First American College of Surgeons\u2013National Surgical Quality Improvement Pro-gram Best Practices Initiative","volume":"207","author":"Campbell","year":"2008","journal-title":"J. Am. Coll. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1001\/jamasurg.2014.1841","article-title":"Surgical Duration and Risk of Venous Thromboembolism","volume":"150","author":"Kim","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1016\/S0140-6736(15)00128-2","article-title":"Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990\u20132013: A systematic analysis for the Global Burden of Disease Study","volume":"386","author":"Forouzanfar","year":"2015","journal-title":"Lancet"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S276","DOI":"10.2337\/dcS13-2023","article-title":"Obesity Paradox Does Exist","volume":"36","author":"Hainer","year":"2013","journal-title":"Diabetes Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1097\/00007890-201407151-02070","article-title":"Perirenal and Intra-Abdominal Fat Mass is Superior to BMI in Predicting Outcome of Laparoscopic Donor Nephrectomy","volume":"98","author":"Lafranca","year":"2014","journal-title":"Transplantation"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1097\/TP.0000000000000733","article-title":"Relationship and Renal Diagnoses after Living Kidney Donation","volume":"99","author":"Lentine","year":"2015","journal-title":"Transplantation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.kint.2016.10.014","article-title":"Obesity increases the risk of end-stage renal disease among living kidney donors","volume":"99","author":"Locke","year":"2017","journal-title":"Kidney Int."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/1\/155\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:07:00Z","timestamp":1760159220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/1\/155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,5]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1]]}},"alternative-id":["jcm10010155"],"URL":"https:\/\/doi.org\/10.3390\/jcm10010155","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,5]]}}}