Laparoscopic Sleeve Gastrectomy in Kidney Transplant Candidates: a Case Series

  • Sergio Carandina
  • Laurent Genser
  • Manuela Bossi
  • Laura Montana
  • Alexandre Cortes
  • Marie Seman
  • Marc Danan
  • Christophe Barrat
Original Contributions

Abstract

Background

Patients with a body mass index (BMI) >35 kg/m2 who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list.

The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant.

Methods

This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France). All the patients were contraindicated for kidney transplantation due to the presence of morbid obesity.

Results

Nine DDFR patients with a mean BMI of 45.9 kg/m2 underwent LSG for the treatment of obesity. Furthermore, all patients presented with hypertension and sleep apnea and six out nine were diabetics. In the immediate postoperative period, all patients were transferred to the intensive care unit (mean stay of 2.1 days). The only major adverse event was a delayed weaning from mechanical ventilation in one patient. The mean hospital stay was 5.5 days (3–12). The total weight loss (TWL) was 27.1, 33.6, and 39.5 kg at 6, 12, and 18 months, respectively. One patient underwent renal transplantation 18 months after LSG, and the other five patients were actively listed for kidney transplantation.

Conclusions

According to the results of this small sample series, LSG seems to be an effective and safe procedure in DDRF patients with concomitant obesity and can increase access to transplantation.

Keywords

Laparoscopic sleeve gastrectomy Renal failure Kidney transplant Transplantation waiting list 

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Digestive and Metabolic SurgeryAvicenne University Hospital, Assistance Publique—Hôpitaux de Paris (AP-HP), Centre Intégré Nord Francilien de la prise en charge de l’Obésité (CINFO), Université Paris XIII-UFR SMBH “Léonard de Vinci”, AP-HPBobignyFrance
  2. 2.Department of Digestive and Bariatric SurgeryClinique Saint MichelToulonFrance
  3. 3.Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver TransplantationPitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Pierre & Marie Curie UniversityParisFrance
  4. 4.Department of Digestive and Metabolic SurgeryAssistance Publique-Hôpitaux de Paris (AP-HP), Centre Hospitalier Marne-la-ValléeJossignyFrance

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