Largest Single Center Experience of Pre-Transplant Outcomes After Bariatric Surgery in Ethnic Minorities With Chronic Kidney Disease
1Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL
2Medicine, University of Miami/Jackson Memorial Hospital Miami Transplant Institute, Miami, FL, United Kingdom.
Meeting: 2015 American Transplant Congress
Abstract number: A180
Keywords: Obesity
Session Information
Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Background:
Ethnic minorities have disproportionately lower renal transplant rates. The increased prevalence of obesity seen in ethnic minorities further places them at a disadvantage due to exclusion of morbidly obese patients from renal transplantation. Bariatric surgery (BS) may serve as a bridge to transplant.
Objective:
To study the pre-transplant outcomes after BS performed in renal transplant candidates.
Methods:
A review of kidney transplant candidates having BS from 10.1.2009 to 6.1.2014 was performed. Ethnicity, weight and body mass index (BMI) before and after the procedure, attainment of BMI less than 40 (necessary for wait-listing), and post-BS complications were recorded. We also recorded post-BS improvement in metabolic parameters (reduction in doses of anti-diabetic or anti-hypertensive drugs).
Results:
A total of 33 (17 Black, 10 Hispanic and 6 White) patients had pre-transplant BS.
All patients were able to achieve target BMI of less than 40 after BS.
Blacks had a trend to have higher BMI compared to the average BMI of other ethic groups (Hispanics and Whites) (p = 0.05).
See table.
| African American/Black | Hispanic | White | |
| Number of Patients (%) | 17 (52) | 10 (30) | 6 (18) |
| Mean Weight Loss in pounds (standard error) | 98.7 (7.5) | 72.4 (4.9) | 86.4 (15.9) |
| BMI before BS (standard error) | 44.9 (1.0) | 40.8 (1.1) | 43.0 (2.4) |
| % Having Metabolic Improvement | 24 | 30 | 33 |
| % Having complications | 18% | 20% | 50% |
Complications seen included postprandial vomiting and burning, retained foreign body, hyperperistalsis, hypocalcemia due to malabsorption, marginal ulcer development and development of an anastomotic stricture. Increased requirement of insulin post-BS was also reported in one patient.
Differences in mean weight loss, BMI before surgery, metabolic improvement and complications post-BS were not statistically significant when the 3 ethnic groups were compared.
Conclusions:
BS is equally successful, with uniform attainment of target listing weight, in Blacks, Hispanics and Whites. Multidisciplinary transplant teams encouraging increased use of BS in morbidly obese CKD patients may help reduce disparities in renal transplantation in minorities.
To cite this abstract in AMA style:
Thomas I, Gaynor J, Joseph T, Cruz NDeLa, Roth D, Mattiazzi A, Kupin W, Chen L, Burke G, Goldstein M, Ciancio G, Guerra G. Largest Single Center Experience of Pre-Transplant Outcomes After Bariatric Surgery in Ethnic Minorities With Chronic Kidney Disease [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/largest-single-center-experience-of-pre-transplant-outcomes-after-bariatric-surgery-in-ethnic-minorities-with-chronic-kidney-disease/. Accessed December 3, 2024.« Back to 2015 American Transplant Congress