America's chronic obesity epidemic has triggered a crisis in organ donations - because a quarter of prospective donors are too fat to undergo the procedure.
Researchers at the North Shore-LIJ Health System Transplant Center in New York and Feinstein Institute for Medical Research conducted a retrospective analysis which found that morbid obesity can prevent people from potentially donating their kidneys.
In a single-center study, researchers have found that almost a quarter of willing donors were initially excluded because they were obese, according to Dr Mala Sachdeva, of North Shore-LIJ Health System Transplant Center.
Unfit: Researchers have found that almost a quarter of willing kidney donors were rejected because they were obese
And only a small percentage of patients initially deemed too heavy were ultimately able to lose enough weight to donate a kidney, Sachdeva added.
Although there are no established national weight criteria, most centers exclude living donors who have a body mass index (BMI) of 35 or above, according to MedPage.
As a result, America's expanding waistlines may be playing a role in the national organ shortage by shrinking the donor pool, the researchers said.
Currently, about 92,000 patients are waiting for a kidney. As many as 7,000 people on the transplant list die each year, the New York Times has reported.
Ground zero: The research was conducted by doctors at the North Shore-LIJ Health System Transplant Center on Long Island, New York
Waiting for a miracle: There are about 92,000 patients currently waiting for a kidney transplant in the U.S.
Sachdeva and colleagues analyzed 104 potential living kidney donors seen at their institution between 2008 and 2011.
Only 18 per cent of them had a BMI within the normal range (25 or below), while most fell into the overweight-to-obese category: 37 per cent had a BMI between 25 and 30, the rest had a BMI of 30 or above.
Graphic shows the projected percentage of obese and very obese Americans
Doctors were forced to reject nearly a quarter of potential donors because they had a BMI of 35 or higher, which classified them as morbidly obese.
These patients were then referred to a nutritionist who created an individual diet and lifestyle modification plan and followed up with these patients on a monthly basis.
Of the total 23 who were considered morbidly obese, only three succeeded at losing weight and donating a kidney. About a third of the patients failed to lose enough weight. The rest declined for medical reasons, opted out of donating, or did not follow through for other reasons.
To increase the size of the donor pool, Sachdeva believes that transplant centers should put in place more rigorous weight reduction programs, check in more regularly for follow-ups at the transplant center, and join social support groups for motivation.
'Something needs to be done to increase the number of live donors but also to make it as safe as possible for them to donate,' Sachdeva said.
National Kidney Foundation President Dr Lynda Szczech said in a statement that the study points out ‘the impact of obesity as a barrier to donation.’
‘As the kidney transplant waiting list grows, there is a great need for living donors,’ Szczech said in the statement.
A new report released by the Centers for Disease Control and Prevention estimates that US obesity rates will rise to 42 per cent by 2030.
The problem currently affects about 78million adults and 12.5million children.
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