This manuscript discusses the safety and feasibility of donor right liver resection (DRLR) in individuals with a body mass index (BMI) of 30 kg/m2 or higher in the context of living donor liver transplantation (LDLT) [
The authors should be commended for their rigorous methodology, including the use of matching to minimize bias. Their findings reveal no significant differences in major postoperative complications, length of hospital stay, or readmission rates between obese and normal-weight donors. This suggests that with appropriate donor selection and thorough preoperative evaluation, DRLR can be safely performed in selected high-BMI donors, potentially expanding the donor pool in a time of critical organ shortages globally.
However, it is important to note the study’s limitations, including its retrospective nature and the relatively small sample size after matching. Moreover, while the findings suggest that obese donors can be safely incorporated into LDLT programs, the study highlights the importance of strict preoperative assessments, particularly regarding liver steatosis and metabolic health, to manage the technical challenges posed by obesity. Future research, especially prospective and multi-center studies, will be essential in solidifying these results and helping to establish more comprehensive guidelines for the inclusion of obese donors in LDLT.
The author has no conflicts of interest to declare.