Introduction

Involvement of bariatric operations in the peri-transplant setting could be at different stages – prospective living organ donor (group 1), prospective organ recipient (2), patients that are already after transplantation (3), all in order to extend graft availability, prolong the graft survival and reduce morbidity. Different bariatric operations can be used in different settings and various organ transplantations. We examined the effectiveness and safety of bariatric operations in prospective recipients, donors, and transplanted patients in liver, kidney, kidney&pancreas and heart transplantation.

METHODS

We collected all bariatric procedures performed as a preparatory step in these three groups between April 2011 and September 2016 in our center. The data included demographics and graft function, weight, BMI, EWL, and morbidity. Mean follow-up duration was 24 months (2-60).

RESULTS

67 patients underwent bariatric operations ( 30 underwent gastric bypass, 37 sleeve gastrectomy, one duodenal switch, two patients underwent two procedures) in peri-transplant patients. 47 patients involved in the Kidney transplant (six donors, eleven future recipients(on dialysis), 30 transplanted patients, of them two –kidney and pancreas); 18 in the liver, (10 cirrhotics- future recipients, five after OLT (one after kidney+liver), and three – simultaneous liver transplantation with sleeve gastrectomy); three in heart (two listed candidates, one of them on LVAD, one heart transplanted patient).

Among all the transplanted (group 3, all organs, 39 pateints) patients mean preoperative weight and BMI were 118 kg(104-152 kg) and 42 kg/m2 (38 – 50 kg/m2), respectively. Mean postoperative weight and BMI were 84 and 27, respectively. The body weight loss was 33%. There was one short term and one long term weight loss failures. There were six major complications (15%). Three mild rejection in the liver transplanted patients were seen . No graft dysfunctions or losses were encountered. One bariatric procedure-related mortality occurred in a Kidney transplant patient (2.6%).

Two prospective heart recipients (group 2) were delisted due to improvement.

Three out of six kidney donors donated the organs successfully (group 1).

CONCLUSIONS

In this series, bariatric operations appear to be effective and safe in peri-trasplant setting.

CITATION INFORMATION: Keidar A, Yemini R, Ben David M, Nesher E, Vinkler J, Broun M, Mor E. Bariatric Operations at a Service of the Transplant Surgery. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress