Babak J Orandi1, Joshua W Purvis2, Robert M Cannon2, A Blair Smith3, Cora E Lewis4, Norah A Terrault5, Jayme E Locke2. 1. University of Alabama at Birmingham Schools of Medicine, Department of Surgery, United States. Electronic address: borandi@uabmc.edu. 2. University of Alabama at Birmingham Schools of Medicine, Department of Surgery, United States. 3. University of Alabama at Birmingham Schools of Medicine, Department of Anesthesia, United States. 4. University of Alabama at Birmingham Schools of Medicine, Department of Medicine, United States; University of Alabama at Birmingham Schools of Medicine, Public Health, United States. 5. University of Southern California Keck School of Medicine, Department of Medicine, United States.
Abstract
BACKGROUND: As obesity prevalence grows, more end-stage organ disease patients will be precluded from transplant. Numerous reports suggest bariatric surgery in end-stage organ disease may help patients achieve weight loss sufficient for transplant listing. METHODS: We performed a systematic review/meta-analysis of studies of bariatric surgery to achieve solid organ transplant listing. RESULTS: Among 82 heart failure patients, 40.2% lost sufficient weight for listing, 29.3% were transplanted, and 8.5% had sufficient improvement with weight loss they no longer required transplantation. Among 28 end-stage lung disease patients, 28.6% lost sufficient weight for listing, 7.1% were transplanted, and 14.3% had sufficient improvement following weight loss they no longer required transplant. Among 41 cirrhosis patients, 58.5% lost sufficient weight for listing, 41.5% were transplanted, and 21.9% had sufficient improvement following weight loss they no longer required transplant. Among 288 end-stage/chronic kidney disease patients, 50.3% lost sufficient weight for listing and 29.5% were transplanted. CONCLUSIONS: Small sample size and publication bias are limitations; however, bariatric surgery may benefit select end-stage organ disease patients with obesity that precludes transplant candidacy.
BACKGROUND: As obesity prevalence grows, more end-stage organ diseasepatients will be precluded from transplant. Numerous reports suggest bariatric surgery in end-stage organ disease may help patients achieve weight loss sufficient for transplant listing. METHODS: We performed a systematic review/meta-analysis of studies of bariatric surgery to achieve solid organ transplant listing. RESULTS: Among 82 heart failurepatients, 40.2% lost sufficient weight for listing, 29.3% were transplanted, and 8.5% had sufficient improvement with weight loss they no longer required transplantation. Among 28 end-stage lung diseasepatients, 28.6% lost sufficient weight for listing, 7.1% were transplanted, and 14.3% had sufficient improvement following weight loss they no longer required transplant. Among 41 cirrhosispatients, 58.5% lost sufficient weight for listing, 41.5% were transplanted, and 21.9% had sufficient improvement following weight loss they no longer required transplant. Among 288 end-stage/chronic kidney diseasepatients, 50.3% lost sufficient weight for listing and 29.5% were transplanted. CONCLUSIONS: Small sample size and publication bias are limitations; however, bariatric surgery may benefit select end-stage organ diseasepatients with obesity that precludes transplant candidacy.
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