Bariatric Surgery in Renal Transplant Patients


01 February 2017


doi: 10.6002/ect.mesot2016.P35


Objectives: The idea of transplanting organs is not new, nor is the disease of obesity. Obese transplant recipients have greater risk of early death than their cohorts, which is not due to increased rejection but due to obesity-related complications, including arterial hypertension, diabetes, and delayed graft function. Here, our aim was to evaluate the effects of bariatric surgery versus lifestyle changes on outcomes of moderate to severely obese renal transplant recipients.

Materials and methods: Twenty-two morbidly obese patients with stable graft function who underwent bariatric surgery were compared with 44 obese patients on lifestyle management (control group). Both groups were evaluated regarding graft and patient outcomes.

Results: The studied groups were comparable demographically. In the bariatric study group versus control group, we observed that the mean body mass index was 38.49 ± 9.1 versus 44.24 ± 6 (P = .024) at transplant and 34.34 ± 7.6 versus 44.38 ± 6.7 (P = .002) at 6 months of bariatric surgery. Both groups received a more potent induction immunosuppression, but this was significantly higher in the obese nonbariatric control group (P < .05). There were more patients with slow and delayed graft functions in the same nonbariatric group. The 2 groups were comparable regarding new-onset diabetes after transplant, total patients with diabetes, and graft outcomes (P > .05).

Conclusions: Bariatric surgeries are feasible, safe pro cedures for selected obese renal transplant recipients.

Similar articles

Outcomes of renal transplantation in obese recipients.

Bardonnaud N, Pillot P, Lillaz J, Delorme G, Chabannes E, Bernardini S, Guichard G, Bittard H, Kleinclauss F.Transplant Proc. 2012 Nov;44(9):2787-91. doi: 10.1016/j.transproceed.2012.09.031.PMID: 23146525

The impact of pre-transplant obesity on renal transplant outcomes.

Drafts HH, Anjum MR, Wynn JJ, Mulloy LL, Bowley JN, Humphries AL.Clin Transplant. 1997 Oct;11(5 Pt 2):493-6.PMID: 9361948

Single Center Experience With Robotic Kidney Transplantation for Recipients With BMI of 40 kg/m2 Or Greater: A Comparison With the UNOS Registry.

Garcia-Roca R, Garcia-Aroz S, Tzvetanov I, Jeon H, Oberholzer J, Benedetti E.Transplantation. 2017 Jan;101(1):191-196. doi: 10.1097/TP.0000000000001249.PMID: 27152921

Consequences of Recipient Obesity on Postoperative Outcomes in a Renal Transplant: A Systematic Review and Meta-Analysis.

Sood A, Hakim DN, Hakim NS.Exp Clin Transplant. 2016 Apr;14(2):121-8.PMID: 27015529 Review.

Kidney transplantation in the obese transplant candidates: to transplant or not to transplant?

Pham PT, Danovitch GM, Pham PC.Semin Dial. 2013 Sep-Oct;26(5):568-77. doi: 10.1111/sdi.12109. Epub 2013 Jul 9.PMID: 23834018 Review.

Cited by

Bariatric Surgery in Kidney Transplant Candidates and Recipients: Experience at an Asian Center.

Tan SYT, Lee PC, Ganguly S, Kek PC, Kee T, Ho QY, Thangaraju S.J Obes Metab Syndr. 2022 Dec 30;31(4):325-333. doi: 10.7570/jomes21090. Epub 2022 Nov 23.PMID: 36416037 Free PMC article.

Bariatric Surgery Outcomes in Patients with Kidney Transplantation.

Pané A, Molina-Andujar A, Olbeyra R, Romano-Andrioni B, Boswell L, Montagud-Marrahi E, Jiménez A, Ibarzabal A, Viaplana J, Ventura-Aguiar P, Amor AJ, Vidal J, Flores L, de Hollanda A.J Clin Med. 2022 Oct 13;11(20):6030. doi: 10.3390/jcm11206030.PMID: 36294351 Free PMC article.

Bariatric surgery outcomes following organ transplantation: A review study.

Kheirvari M, Goudarzi H, Hemmatizadeh M, Anbara T.World J Exp Med. 2022 Sep 20;12(5):92-99. doi: 10.5493/wjem.v12.i5.92. eCollection 2022 Sep 20.PMID: 36196436 Free PMC article. Review.

Management of obesity in kidney transplant candidates and recipients: A clinical practice guideline by the DESCARTES Working Group of ERA.

Oniscu GC, Abramowicz D, Bolignano D, Gandolfini I, Hellemans R, Maggiore U, Nistor I, O'Neill S, Sever MS, Koobasi M, Nagler EV.Nephrol Dial Transplant. 2021 Dec 24;37(Suppl 1):i1-i15. doi: 10.1093/ndt/gfab310.PMID: 34788854 Free PMC article.

Bariatric surgery in transplant recipients: A narrative review.

Kermansaravi M, Davarpanah Jazi AH, Talebian P, Rokhgireh S, Kabir A, Pazouki A.J Res Med Sci. 2021 Jul 31;26:44. doi: 10.4103/jrms.JRMS_631_19. eCollection 2021.PMID: 34484376 Free PMC article. Review.