Your browser doesn't support javascript.
loading
Bariatric Surgery as a Bridge to Facilitate Renal Transplantation in Patients with End-Stage Renal Disease.
Bosch, Karen D; Harrington, Cuan; Sulutaura, Liene; Lacea, Emilane; Burton, Katarina; Fernandez-Munoz, Naiara; Dugal, Neal; Sufi, Pratik; Al Midani, Ammar; Parmar, Chetan.
Afiliación
  • Bosch KD; Department of Bariatric Surgery, Whittington Health NHS Trust, London, N19 5NF, UK. karen.bosch@nhs.net.
  • Harrington C; Department of Surgery, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK.
  • Sulutaura L; Department of Bariatric Surgery, Whittington Health NHS Trust, London, N19 5NF, UK.
  • Lacea E; Department of Bariatric Surgery, Whittington Health NHS Trust, London, N19 5NF, UK.
  • Burton K; Department of Bariatric Surgery, Whittington Health NHS Trust, London, N19 5NF, UK.
  • Fernandez-Munoz N; Department of Bariatric Surgery, Whittington Health NHS Trust, London, N19 5NF, UK.
  • Dugal N; National Kidney Transplant Service, Beaumont Hospital, Dublin, D09V2N0, Ireland.
  • Sufi P; Department of Bariatric Surgery, Whittington Health NHS Trust, London, N19 5NF, UK.
  • Al Midani A; Department of Renal Transplantation, Royal Free Hospitals NHS Foundation Trust, London, NW3 2QG, UK.
  • Parmar C; Department of Surgery, Whittington Hospital, London, N19 5NF, UK.
Obes Surg ; 34(2): 355-362, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38172424
ABSTRACT

PURPOSE:

Renal transplantation (RT) is not recommended above BMI 40 kg/m2 as post-operative risks (delayed graft function, wound complications) are increased. Bariatric surgery (BS) results in sustained long-term weight loss. However, renal failure (RF) patients are theoretically higher risk candidates. We aim to investigate the safety of BS in patients with RF and the effect of BS on access to renal transplantation.

METHODS:

We reviewed data from 31 patients with RF referred for BS between 2013 and 2021. We compared the outcomes of patients with RF who underwent BS to those who were referred but did not undergo BS. Controls matched for age/BMI/comorbidity (MC) but without RF were used for comparison.

RESULTS:

Of 31 patients referred, 19 proceeded with BS (68% female, median age 52 years, BMI 46.2 ± 4.9 kg/m2) and 12 did not (58% female, median age 58, mean BMI 41.5 ± 4.1). Excess body weight loss (EBWL) was 71.2% ± 20.2% at 2 years in RF patients versus 66.0% ± 28.0% in MC patients. In the operated group, 11/19 (58%) patients reached their treatment target (six transplanted, five placed on waiting list) versus 3/12 (25%) in unoperated patients (three transplanted). There was no difference in perioperative complications between RF and MC groups. Long-term, there were seven deaths amongst RF patients (two operated, five unoperated), none amongst the MC group.

CONCLUSION:

BS in patients with RF increased access to RT and was safe and effective. We therefore recommend consideration of BS in patients with obesity and RF in specialised units.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Trasplante de Riñón / Cirugía Bariátrica / Fallo Renal Crónico Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Trasplante de Riñón / Cirugía Bariátrica / Fallo Renal Crónico Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos