Introduction

In many transplant centers, patients with a BMI above 40 kg/m2 are either completely excluded or required to lose weight before being considered for kidney transplantation. Herein, we present the first experience of combined robotic kidney transplantation (RKT) and sleeve gastrectomy (RSG).

Materials and Methods

This is an IRB-approved protocol to assess the safety and efficacy of simultaneous RSG and RKT. Six patients achieved a 12 month follow-up. We compared the first 4 patients who underwent the combined approach (study group) with 2 patient who underwent the standard weight loss program after RKT (control group).

Results

The mean age was 45±6.5 years in the study group and 42.5±4.5 years in the control group. The mean BMI was 39.9±1.4 kg/m2 in the study group and 40.5±0.2 kg/m2 in the control group. At 12 months, the mean GFR was 71.7±9.8 ml/min/1.73m2 in the study group and 51.4±15.4 ml/min/1.73m2 in the control group. At 12 months, the mean BMI was 29±2.7 kg/m2 in the study group and 40.7±0.3 kg/m2 in the control group. There were no surgical or medical complications related to the combined procedures. The study group presented with no difficulties in maintaining immunosuppression, as well as no episodes of acute cellular or antibody mediated rejection.

Conclusion

Our preliminary results show the safety and feasibility of simultaneous RKT and RSG. This single procedure achieved encouraging results in terms of weight loss and kidney function after a 12 month follow-up period. However, the conclusion of our study will be necessary to confirm the success of these initial data.

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