Laparoscopic Sleeve Gastrectomy in Obese Renal Transplant Candidates

T. Diwan, C. Freeman, R. Alloway, A. Rikes-Shields, G. Moglishetty, A. Govil, M. Cardi, R. Munda, S. Shah, M. Cuffy, F. Paterno, S. Woodle

Division of Transplant Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
Division of Nephrology, University of Cincinnati College of Medicine, Cincinnati, OH
Division of Nephrology, The Christ Hospital, Cincinnati, OH

Meeting: 2013 American Transplant Congress

Abstract number: D1485

Dialysis is associated with high mortality, and obesity often precludes transplantation. Weight loss prior to transplantation may reduce the morbidity and mortality associated with transplantation. The aim of this study is to determine the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in renal transplant candidates.

Methods Ten patients underwent LSG by a single surgeon between December 2011 and August 2012. NIH guidelines for morbid obesity surgery were used for candidacy.

ResultsDemographics, BMI, anti-hypertensive medications, and insulin requirement are described in Tables 1&2. The mean follow up after LSG was 111 days. There were no perioperative complications (including leak, pulmonary embolism, and wound infection) and length of stay was 3 (2-5) days. Mean operative time was 133 min with blood loss of 25ml. The percentage of excess weight loss was 34.1 and BMI was reduced by 5.8 kg/m². Five patients obtained goal BMI of <35 kg/m² with average length to goal of 37days. One patient underwent transplant post LSG.

Conclusion LSG is a safe and efficacious means to obtain weight loss in ESRD patients and could improve transplant outcomes and increase patient eligibility.

Demographics
Age (years)	47 (18-67)
Male (%)	50
Sleep Apnea (%)	60
Hemodialysis dependent (%)	100
Smoker (%)	20

Preoperative and Postoperative Data
	Pre	Post
BMI	41.2 (35.7-46.7)	35.6 (30.8-45.5)
Number of antihypertensive medications	1.4 (0-3)	0.9 (0-1)
Insulin Glargine per day (units)	30 (0-140)	14 (0-70)
Transplant eligibility (%)	0	50

To cite this abstract in AMA style:

Diwan T, Freeman C, Alloway R, Rikes-Shields A, Moglishetty G, Govil A, Cardi M, Munda R, Shah S, Cuffy M, Paterno F, Woodle S. Laparoscopic Sleeve Gastrectomy in Obese Renal Transplant Candidates [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/laparoscopic-sleeve-gastrectomy-in-obese-renal-transplant-candidates/. Accessed October 30, 2024.

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