BACKGROUND: The prevalence of obesity and obesity-related morbidity in end-stage renal disease patients is rising. Although it is established that obesity does not abrogate the transplant benefit with respect to lower long-term mortality and cardiovascular risk, it is associated with increased graft failure, delayed graft function, surgical complications, prolonged hospital stay, and costs. OBJECTIVES: To examine the safety and efficacy of LSG (laparoscopic sleeve gastrectomy) in renal transplant candidates and evaluate transplant outcomes. SETTING: Single-center prospective nonrandomized trial METHODS: We here report on a prospective single-center trial establishing a 2-step approach for obese renal transplant candidates. Patients with end-stage renal disease and a BMI (body mass index) of 35 kg/m2 or higher underwent laparoscopic sleeve gastrectomy. After reaching a BMI of<35 kg/m2, patients were waitlisted for kidney transplantation. Age, gender, body mass index (BMI), associated co-morbidities, cause of end-stage renal disease, surgical complications, and outcome after kidney transplantation (graft survival, incidence of delayed graft function, incidence of rejection, serum creatinine) were collected. RESULTS: LSG was performed in 8 renal transplant candidates with a mean BMI of 38.8 kg/m2 each. BMI dropped to below 35 kg/m2 within a median of 3 months. Percent excess body mass index loss (%EBMIL) was 62.7% at 1 year after LSG. Within 17 months (mean) after metabolic surgery, 7 patients underwent kidney transplantation. All transplants were successful with a serum creatinine of 1.9±.8 mg/dL at discharge and stable allograft function thereafter. Mean follow-up was 3.2±1.4 years; no patient was lost to follow-up. CONCLUSION: LSG is safe and efficacious for treatment of obesity in renal transplant candidates. Rapid and sustained weight loss and subsequent waitlisting for kidney transplantation may reduce overall and in particular posttransplant patient morbidity.
BACKGROUND: The prevalence of obesity and obesity-related morbidity in end-stage renal diseasepatients is rising. Although it is established that obesity does not abrogate the transplant benefit with respect to lower long-term mortality and cardiovascular risk, it is associated with increased graft failure, delayed graft function, surgical complications, prolonged hospital stay, and costs. OBJECTIVES: To examine the safety and efficacy of LSG (laparoscopic sleeve gastrectomy) in renal transplant candidates and evaluate transplant outcomes. SETTING: Single-center prospective nonrandomized trial METHODS: We here report on a prospective single-center trial establishing a 2-step approach for obese renal transplant candidates. Patients with end-stage renal disease and a BMI (body mass index) of 35 kg/m2 or higher underwent laparoscopic sleeve gastrectomy. After reaching a BMI of<35 kg/m2, patients were waitlisted for kidney transplantation. Age, gender, body mass index (BMI), associated co-morbidities, cause of end-stage renal disease, surgical complications, and outcome after kidney transplantation (graft survival, incidence of delayed graft function, incidence of rejection, serum creatinine) were collected. RESULTS: LSG was performed in 8 renal transplant candidates with a mean BMI of 38.8 kg/m2 each. BMI dropped to below 35 kg/m2 within a median of 3 months. Percent excess body mass index loss (%EBMIL) was 62.7% at 1 year after LSG. Within 17 months (mean) after metabolic surgery, 7 patients underwent kidney transplantation. All transplants were successful with a serum creatinine of 1.9±.8 mg/dL at discharge and stable allograft function thereafter. Mean follow-up was 3.2±1.4 years; no patient was lost to follow-up. CONCLUSION: LSG is safe and efficacious for treatment of obesity in renal transplant candidates. Rapid and sustained weight loss and subsequent waitlisting for kidney transplantation may reduce overall and in particular posttransplant patient morbidity.
Authors: Babak J Orandi; Joshua W Purvis; Robert M Cannon; A Blair Smith; Cora E Lewis; Norah A Terrault; Jayme E Locke Journal: Am J Surg Date: 2020-06-13 Impact factor: 2.565
Authors: Shazia Jehan; Ferdinand Zizi; Seithikurippu R Pandi-Perumal; Steven Wall; Evan Auguste; Alyson K Myers; Girardin Jean-Louis; Samy I McFarlane Journal: Sleep Med Disord Date: 2017-12-12
Authors: Rashikh A Choudhury; Gerard Hoeltzel; Kas Prins; Eric Chow; Hunter B Moore; Peter J Lawson; Dor Yoeli; Akshay Pratap; Peter L Abt; Kristoffel R Dumon; Kendra D Conzen; Trevor L Nydam Journal: J Gastrointest Surg Date: 2019-05-01 Impact factor: 3.452
Authors: Juliane Liese; Nils Bottner; Stefan Büttner; Alexander Reinisch; Guido Woeste; Markus Wortmann; Ingeborg A Hauser; Wolf Otto Bechstein; Frank Ulrich Journal: Langenbecks Arch Surg Date: 2017-05-10 Impact factor: 3.445
Authors: Karen J Coleman; Yu-Hsiang Shu; Heidi Fischer; Eric Johnson; Tae K Yoon; Brianna Taylor; Talha Imam; Stephen DeRose; Sebastien Haneuse; Lisa J Herrinton; David Fisher; Robert A Li; Mary Kay Theis; Liyan Liu; Anita P Courcoulas; David H Smith; David E Arterburn; Allon N Friedman Journal: Ann Surg Date: 2021-03-03 Impact factor: 13.787