Gastric Bypass Does Not Negatively Affect Kidney Transplant Outcomes.
University of Minnesota, Minneapolis.
Meeting: 2016 American Transplant Congress
Abstract number: C240
Keywords: Outcome
Session Information
Date: Monday, June 13, 2016
Session Name: Poster Session C: Poster Session 1: Kidney Complications-Other
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction: Bariatric surgery is the most effective treatment for obesity, but has been associated with adverse renal outcomes. Limited data exist on the impact of pre-kidney transplant (ktx) gastric bypass (GBP) on post tx outcomes. We compared patient and allograft outcomes in 46 ktx with GBP to 4625 controls.
Methods: Study population consists of patient transplanted from 1990 to 2015. 46 patients with bariatric surgery prior to transplant were identified. We compared incidence of acute rejection in first 6 month post-tx, patient and allograft survivals between the 2 groups.
Results: Mean time between GBP and ktx was 8.6±1.4 years. GBP pts were older (p=0.005), predominantly female (p<0.0001) and diabetic (p=0.002). More controls were on AZA, steroids and Cyclosporine and more GBP pts were on MMF and Tacrolimus. Mean time of follow up was 3.9±0.5 years for GBP pts and 8.9±0.1 years for controls (p<0.0001).
| n | Controls(4625) | GBP(46) | p value |
| Age at transplant | 44.2(0.2) | 51.1(1.7) | 0.005 |
| Male, % | 60.7 | 28.3 | <0.0001 |
| Living Donor, % | 50.8 | 26.1 | 0.0008 |
| Time of follow up, years | 8.9(0.1) | 3.9(0.5) | <0.0001 |
| Cornonary artery disease, % | 34.1 | 26.1 | 0.4 |
| Diabetes, % | 44.7 | 71.1 | 0.002 |
| Azathioprine, % | 34 | 0 | |
| MMF, % | 65 | 100 | <0.0001 |
| Cyclosporine | 59 | 45 | 0.06 |
| Tacrolimus,, % | 36 | 54 | 0.01 |
| Prednisone, % | 52% | 22% | <0.0001 |
24 % of GBP and 29 % of controls had acute rejection in first six months (p=0.002). 11% of GBP and 19% of controls experienced ktx failure (P=0.01). There was no difference in patient survival between two groups after adjusting for age at transplant, race, sex, living vs. diseased donor, diabetes, hypertension, coronary artery disease, recipient CMV status, rejection, preemptive transplant and time of follow up.
| n | Controls(4625) | GBP(46) | p value |
| Rejections, n(%) | 1323(29) | 11(24) | |
| HR(95% CI) | 1 | 0.31(0.16,0.54) | 0.002 |
| Allograft failure, n(%) | 870(19) | 5(11) | |
| HR(95% CI) | 1 | 0.31(0.11,0.69) | 0.01 |
| Death, n(%) | 1673(36) | 8(17) | |
| HR(95% CI) | 1 | 0.7(0.3,1.37) | 0.4 |
Conclusion: Gastric bypass surgery is not associated with adverse outcomes after kidney transplant. There were more rejections and ktx failure in the control group.
CITATION INFORMATION: Goyal N, Sanchez O, Issa N, Matas A, Ibrahim H, Kukla A. Gastric Bypass Does Not Negatively Affect Kidney Transplant Outcomes. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Goyal N, Sanchez O, Issa N, Matas A, Ibrahim H, Kukla A. Gastric Bypass Does Not Negatively Affect Kidney Transplant Outcomes. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/gastric-bypass-does-not-negatively-affect-kidney-transplant-outcomes/. Accessed April 10, 2020.« Back to 2016 American Transplant Congress