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Obesity Surgery

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01-08-2019 | Kidney Transplantation | Original Contributions

Bariatric Surgery Is Efficacious and Improves Access to Transplantation for Morbidly Obese Renal Transplant Candidates

Authors: Renana Yemini, Eviatar Nesher, Idan Carmeli, Janos Winkler, Ruth Rahamimov, Eytan Mor, Andrei Keidar

Published in: Obesity Surgery | Issue 8/2019

Abstract

Background

The surgical risk of morbidly obese patients is high and even higher for kidney transplant candidates. A BMI > 35–40 kg/m² is often a contraindication for that surgery. The safety, feasibility, and outcome of bariatric surgery for those patients are inconclusive.

Methods

We conducted a retrospective chart review of prospectively collected data on morbidly obese renal transplant candidates who underwent laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) in our institution between January 2009 and September 2017. The reported outcome included body weight and graft status after a mean follow-up of 47 months (range 0.5–5 years).

Results

Twenty-four patients (8 females, 16 males, average age 54 years, average preoperative BMI 41 kg/m² [range 35–51]) underwent LSG (n = 17) or LRYGB (n = 7). Sixteen of them (67%) proceeded to kidney transplantation. Of the 8 pre-transplant and post-bariatric surgery patients, 5 are on the waitlist, and 2 patients died (one of staple line leakage, and one from sepsis unrelated to the bariatric surgery). The average time from bariatric surgery to transplantation was 1.5 years (range 1 month to 4.3 years). The average pre-transplantation BMI was 28 kg/m² (range 19–36). The mean percentage of excess weight loss was 66% (n = 21), and the total percentage of weight loss was 29% (n = 21). Comorbidities (type 2 diabetes, hypertension, and dyslipidemia) improved significantly following both surgical approaches.

Conclusions

LSG and LRYGB appear to effectively address obesity issues before kidney transplantation and improve surgical access. Morbidly obese transplant candidates would benefit from prior bariatric surgery.

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Title: Bariatric Surgery Is Efficacious and Improves Access to Transplantation for Morbidly Obese Renal Transplant Candidates
Authors: Renana Yemini
Eviatar Nesher
Idan Carmeli
Janos Winkler
Ruth Rahamimov
Eytan Mor
Andrei Keidar
Publication date: 01-08-2019
Publisher: Springer US
Keywords: Kidney Transplantation
Obesity
Obesity
Sleeve Gastrectomy
Bariatric Surgery
Bariatric Surgery
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Published in: Obesity Surgery / Issue 8/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-019-03925-1

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Bariatric Surgery Is Efficacious and Improves Access to Transplantation for Morbidly Obese Renal Transplant Candidates

Abstract

Background

Methods

Results

Conclusions

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Abstract

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