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01-08-2021 | Kidney Transplantation | Original Contributions

Effectiveness of Bariatric Surgery in Increasing Kidney Transplant Eligibility in Patients with Kidney Failure Requiring Dialysis

Authors: Basem G. Soliman, Nabil Tariq, Yi Ying Law, Stephanie Yi, Nwabunie Nwana, Rita Bosetti, Bita Kash, Linda W. Moore, A. Osama Gaber, Vadim Sherman

Published in: Obesity Surgery | Issue 8/2021

Abstract

Purpose

Severe obesity can increase risk of complications after kidney transplantation. There is a paucity of literature on bariatric surgery outcomes in renal transplant candidates. The objective of this study was to analyze outcomes of bariatric surgery as a weight reduction strategy for patients with kidney failure to enhance eligibility for kidney transplantation.

Materials and Methods

We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database at a single institution for patients with chronic kidney disease receiving hemodialysis therapy (CKD G5D) undergoing bariatric surgery between 2011 and 2018.

Results

Of 2363 patients who underwent bariatric surgery, 38 (1.6%) had CKD G5D; median age (range) was 49 years (33; 69), 52.6% were female, and mean BMI was 44.2 kg/m². Twenty-four patients underwent laparoscopic Roux-en-Y gastric bypass (LRYGB), and 14 patients underwent laparoscopic sleeve gastrectomy. Seventeen patients (46%, n=37) had a BMI≤35 at 6 months, while 25 patients (75.8%, n=33) achieved a BMI≤35 at 12 months. Of these, 18 patients (47%) were listed for kidney transplant, and 8 patients (21%) received kidney transplant. There was no statistically significant difference between sleeve and LRYGB procedures in patients who reached BMI of 35 at 12 months (P=0.58). Median length of stay was 2.3 days. Thirty-day readmission rate was 2 patients (5.3%), and 2 patients (5.3%) required reoperation (one for bleeding, one for acute recurrent hiatal hernia). No mortality occurred.

Conclusion

Laparoscopic bariatric surgery offers effective weight loss for CKD G5D patients to achieve transplant eligibility with acceptable outcomes.

Graphical abstract

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Title: Effectiveness of Bariatric Surgery in Increasing Kidney Transplant Eligibility in Patients with Kidney Failure Requiring Dialysis
Authors: Basem G. Soliman
Nabil Tariq
Yi Ying Law
Stephanie Yi
Nwabunie Nwana
Rita Bosetti
Bita Kash
Linda W. Moore
A. Osama Gaber
Vadim Sherman
Publication date: 01-08-2021
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 8/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-021-05435-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effectiveness of Bariatric Surgery in Increasing Kidney Transplant Eligibility in Patients with Kidney Failure Requiring Dialysis

Abstract

Purpose

Materials and Methods

Results

Conclusion

Graphical abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

Graphical abstract

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