Laparoscopic sleeve gastrectomy as a weight reduction strategy in obese patients after kidney transplantation

Abstract

Morbid obesity is associated with increased graft loss and shortened graft survival in kidney transplant patients. Treating obesity in transplant patients may improve graft outcomes. Laparoscopic sleeve gastrectomy (LSG), an effective bariatric operation, is relatively unlikely to interfere with absorption of anti-rejection medications. Data on relevant renal function parameters were collected from all LSGs performed on renal transplant patients at our center (n = 10). The procedure was successful in eight patients, with no mortality, graft rejection or dysfunction. The median age and follow-up were 57 years and 14 months, respectively. Seven patients had over 1 year of follow-up. The median preoperative weight and BMI were 119 kg (96-152) and 42 kg/m(2) (37-49), respectively. The median hospital stay was 4 days. The median postoperative weight and BMI at 6 months and 1 year were 86 kg and 31 kg/m(2) and 83 kg and 29 kg/m(2) , respectively. Urinary protein excretion and serum creatinine decreased significantly in all patients (p < 0.05). One patient developed two complications, acute renal failure and sleeve stricture, both of which resolved with treatment. LSG provided effective weight loss in renal transplant patients without adverse effects on graft function and immunosuppression.

Keywords: Clinical research/practice; hyperlipidemia; hypertension/antihypertensives; kidney (allograft) function/dysfunction; kidney transplantation/nephrology; obesity; patient survival.