Mililani resident Robert “Chris” Groom has been waiting almost two years for a kidney transplant, but that’s not because he doesn’t have a donor.

His sister was found to be a twin, or perfect match, for him and has agreed to donate one of her kidneys to save his life.

But doctors have put the surgery on hold until Groom’s weight drops to 230 pounds. The 48-year-old Kaiser Permanente Hawaii member said he lost more than 50 pounds last year, but his weight has plateaued, fluctuating between 250 and 260 pounds, even with dieting and daily exercise.

“I just get the feeling they’re just trying to pad their success rates,” he said. “My wife and I feel hopeless and lost. My hopes and dreams are slowly fading away. I want to see my daughter graduate college and get married and have kids. I want to live.”

An increasing number of people are being disqualified from donating and receiving organs due to obesity. As obesity rises, the number of potential donors decreases, leaving more people on the waiting list, according to the National Kidney Foundation of Hawaii.

“Obesity is a reason and a barrier to having more kidney transplants from living donors as well as possible recipients on the waiting list,” said Glen Hayashida, the foundation’s president and CEO. “The surgery would put either a kidney donor or recipient at too high a risk for complications.”

Not all transplant centers refuse to perform surgeries on those with a body mass index — an estimate of body fat based on height and weight — of 30 (generally the definition of obesity), he said, though some providers don’t want to take on patients with an increased risk for transplant failure, wound infection, heart complications and slower healing time.

“The centers want to minimize their risk for an unsuccessful transplant,” Hayashida said. “Although the primary reason is the health of the transplant recipient … the centers are also evaluated on their outcomes. So an unsuccessful kidney transplant within the first year reflects very badly on the center. Of course, if there is a complication, then there is an increase in cost.”

Kaiser spokeswoman Laura Lott said she was not able to talk specifically about Groom’s case due to patient privacy laws. But Lott said the company — both a medical provider and health insurer — has “many options to help our members manage their weight,” including dietitians and lifestyle coaches that work with patients one-on-one or via telephone.

Groom, who is on peritoneal dialysis for 8.5 hours daily seven days a week, was diagnosed with stage 4 kidney failure in March 2017, weighing in at more than 300 pounds. He said he was told to lose weight in order to do the transplant but that doctors did not give him a specific amount at the time. Kaiser contracts with the University of California, San Francisco Medical Center, a research and teaching hospital for the transplants. UCSF Medical Center representatives weren’t immediately available for comment.

Groom works at the Pearl Harbor shipyard from 6 a.m. to 2:30 p.m. then heads to the gym for an hour and a half, he said, adding that he also eats minimally. Kaiser has told him he could have bariatric surgery to lose weight, but not a kidney transplant, he said, adding that doctors are using the standard weight-height average, not taking into account that locals are built differently.

“I don’t know what else to do. I don’t snack all day long, basically eat three small meals a day,” he said. “Towards the end of the day I’m kind of exhausted. There’s some days I’m actually kind of depressed. If it wasn’t for my family I’d probably given up.”

His sister Cathy Sonsona, 45, said being a donor was a difficult decision since she has three children, but she is “not going to let my brother die.”

“He’s all I got,” Sonsona said. “I see my brother’s health. He’s having trouble walking, having swollen feet, getting cysts in his hair, a side effect from dialysis.”

Doctors are also requiring the 131-pound mother to lose as much as 16 pounds before the process can begin — and before she might develop diabetes, she said.

Groom said it’s frustrating for him that 3,500 kidneys are thrown away each year in the U.S. while there are “people out there who need kidneys and can’t get them.”