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. 2023 Jan;37(1):494-502.
doi: 10.1007/s00464-022-09552-9. Epub 2022 Aug 24.

Outcomes of kidney transplant recipients who underwent pre-transplant bariatric surgery for severe obesity: a long-term follow-up study

Roxaneh Zaminpeyma  1 , Matias Claus  2 , Steven Paraskevas  1 , Olivier Court  2 , Jean Tchervenkov  1 , Amin Andalib  3   4
Affiliations

Outcomes of kidney transplant recipients who underwent pre-transplant bariatric surgery for severe obesity: a long-term follow-up study

Roxaneh Zaminpeyma et al. Surg Endosc. 2023 Jan.

Abstract

Background: Kidney transplantation (KT) is the preferred therapy for end-stage renal disease (ESRD). While a major cause for ESRD, obesity is also a key obstacle to candidacy for KT. Bariatric surgery, particularly sleeve gastrectomy (SG), is increasingly used to improve access to KT in patients with obesity, but the literature especially on outcomes post-KT remains lacking. We aimed to provide a long-term follow-up analysis of efficacy and outcomes of a previously described cohort of patients with obesity, who had SG as a means for access to KT.

Methods: This is a single-center retrospective follow-up study of 32 patients with advanced chronic kidney disease or ESRD, who were referred and underwent SG between 2013 and 2018 as an access strategy to KT. The primary outcome was successful KT. Ninety-day outcomes, long-term graft function, and changes in weight and obesity-related comorbidities after KT were assessed. Descriptive statistics are presented as count (percentage) or median (interquartile range).

Results: At baseline, 18 (56%) were male with a median age and BMI of 51 (11) years and 42.3 (5.2) kg/m2, respectively. Median follow-up time post-SG was 53 (58) months. At last follow-up, 23 (72%) patients received KT. Median time to KT was 16 (20) months and BMI was 34.0 (5.1) kg/m2 at time of transplant. At KT, 13 (57%) and 20 (87%) had diabetes and hypertension, respectively. Median follow-up post-KT was 16 (47) months. There was one graft loss requiring return to dialysis. At 5-year post-KT, median serum creatinine was 136 (66) µmol/l. At last follow-up post-KT, median BMI remained at 33.7 (7.6) kg/m2. Among patients with diabetes and hypertension, 7/13 (54%) and 5/20 (25%) had either improvement or remission of their comorbidities, respectively.

Conclusion: SG is an effective strategy to improve access to KT in patients with severe obesity. Transplant recipients also continue to benefit from sustained weight loss and improved related comorbidities that may positively impact their graft function after KT.

Keywords: Bariatric surgery; Dialysis; End-stage renal disease; Kidney transplant; Obesity; Sleeve gastrectomy.

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Conflict of interest statement

Roxaneh Zaminpeyma, Matias Claus, Steven Paraskevas, Olivier Court, Jean Tchervenkov, and Amin Andalib have no conflicts of interest or financial ties to disclose.

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References

    1. Kovesdy CP, Furth SL, Zoccali C, World Kidney Day Steering Committee Obesity and kidney disease: hidden consequences of the epidemic. J Nephrol. 2017;30:1–10. doi: 10.1007/s40620-017-0377-y. - DOI - PubMed
    1. Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, Klarenbach S, Gill J. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011;11:2093–2109. doi: 10.1111/j.1600-6143.2011.03686.x. - DOI - PubMed
    1. Segev DL, Simpkins CE, Thompson RE, Locke JE, Warren DS, Montgomery RA. Obesity impacts access to kidney transplantation. J Am Soc Nephrol. 2008;19:349–355. doi: 10.1681/ASN.2007050610. - DOI - PMC - PubMed
    1. Chang AR, Grams ME, Navaneethan SD. Bariatric surgery and kidney-related outcomes. Kidney Int Rep. 2017;2:261–270. doi: 10.1016/j.ekir.2017.01.010. - DOI - PMC - PubMed
    1. Chan G, Soucisse M. Survey of Canadian kidney transplant specialists on the management of morbid obesity and the transplant waiting list. Can J Kidney Health Dis. 2016;3:2054358116675344. doi: 10.1177/2054358116675344. - DOI - PMC - PubMed