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Kidney transplantation after sleeve gastrectomy in the morbidly obese candidate: results of a 2-year experience.

Publication ,  Journal Article
Kim, Y; Bailey, AJ; Morris, MC; Kassam, A-F; Shah, SA; Diwan, TS
Published in: Surg Obes Relat Dis
January 2020

BACKGROUND: Morbid obesity serves as a barrier to kidney transplantation (KT) due to potential suboptimal posttransplant outcomes. Laparoscopic sleeve gastrectomy (LSG) has previously been shown to improve transplant eligibility through weight loss. OBJECTIVES: We aimed to examine the role LSG plays in improving patient outcomes postrenal transplantation, including possible impact on new-onset diabetes after transplant (NODAT). SETTING: University Hospital. METHODS: A single-center analysis was performed identifying all patients who underwent KT after LSG from 2011 to 2017 (n = 41). Exclusion criteria included type I diabetes and previous pancreas transplantation. NODAT was defined as a new insulin requirement after KT. Delayed graft function was defined as need for dialysis within the first week after KT. Mean posttransplant follow-up period was 22 months. RESULTS: Forty-one patients underwent KT after LSG after median time of 16 months. Median age of postLSG patients undergoing KT was 56.0 years at time of KT. Average body mass index decreased by 9 from the time of LSG to KT, and no patients regained weight at 1-year follow-up. After LSG, the number of patients with hypertension (85.4% versus 48.5%) and the number of antihypertensive medications used decreased significantly (1.6 versus .6) at time of KT (P < .001 each). At 1-year follow-up, the improvement in hypertension persisted (51.2% versus 48.5%, P = nonsignificant). The average insulin regimen decreased from 33.0 ± 51.6 to 11.7 ± 21.5 units at KT (P < .001). This improvement also persisted at 1-year follow-up (11.9 versus 11.7 units, P = nonsignificant). Zero patients suffered NODAT over the follow-up period (versus institutional rate of NODAT at 15.8%). One patient developed delayed graft function (2.4%, versus institutional rate of 13.3%). After 1 year postKT, there was 1 graft loss (2.4%) and no mortality. CONCLUSION: This is the largest reported series of KT after planned LSG in morbidly obese patients. Our results confirm excellent posttransplant outcomes among patients who otherwise would have been denied KT eligibility.

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Published In

Surg Obes Relat Dis

DOI

EISSN

1878-7533

Publication Date

January 2020

Volume

16

Issue

1

Start / End Page

10 / 14

Location

United States

Related Subject Headings

  • Weight Loss
  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Kim, Y., Bailey, A. J., Morris, M. C., Kassam, A.-F., Shah, S. A., & Diwan, T. S. (2020). Kidney transplantation after sleeve gastrectomy in the morbidly obese candidate: results of a 2-year experience. Surg Obes Relat Dis, 16(1), 10–14. https://doi.org/10.1016/j.soard.2019.09.069
Kim, Young, Amanda J. Bailey, Mackenzie C. Morris, Al-Faraaz Kassam, Shimul A. Shah, and Tayyab S. Diwan. “Kidney transplantation after sleeve gastrectomy in the morbidly obese candidate: results of a 2-year experience.Surg Obes Relat Dis 16, no. 1 (January 2020): 10–14. https://doi.org/10.1016/j.soard.2019.09.069.
Kim Y, Bailey AJ, Morris MC, Kassam A-F, Shah SA, Diwan TS. Kidney transplantation after sleeve gastrectomy in the morbidly obese candidate: results of a 2-year experience. Surg Obes Relat Dis. 2020 Jan;16(1):10–4.
Kim, Young, et al. “Kidney transplantation after sleeve gastrectomy in the morbidly obese candidate: results of a 2-year experience.Surg Obes Relat Dis, vol. 16, no. 1, Jan. 2020, pp. 10–14. Pubmed, doi:10.1016/j.soard.2019.09.069.
Kim Y, Bailey AJ, Morris MC, Kassam A-F, Shah SA, Diwan TS. Kidney transplantation after sleeve gastrectomy in the morbidly obese candidate: results of a 2-year experience. Surg Obes Relat Dis. 2020 Jan;16(1):10–14.
Journal cover image

Published In

Surg Obes Relat Dis

DOI

EISSN

1878-7533

Publication Date

January 2020

Volume

16

Issue

1

Start / End Page

10 / 14

Location

United States

Related Subject Headings

  • Weight Loss
  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Humans