Adults with kidney disease, obesity eligible for transplant after weight-loss surgery
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Key takeaways:
- Overall, 36 patients opted for weight loss procedures and 10 received a transplant.
- There was a 27% reduction in average BMI at the time of transplant.
Adults with obesity and end-stage renal disease may qualify as kidney transplant candidates, according to a joint study between a bariatric and transplant surgery team.
“We’ve seen that bariatric surgery is not just about weight loss, it significantly improves other serious conditions like diabetes, high blood pressure and sleep apnea,” corresponding author Anil Paramesh, MD, MBA, FACS, professor of surgery, urology and pediatrics and director of the kidney and pancreas transplant programs at Tulane University School of Medicine in New Orleans, said in a press release. “This approach not only helps in reducing the patients’ weight to a level where they can safely receive a transplant, but also addresses the broader issue of health care disparities, particularly affecting Black and lower-income individuals.”
In a study conducted from 2019 to 2023, researchers followed 183 patients with ESRD, who were referred for bariatric surgery. The goal of the study was to explore whether metabolic and bariatric procedures could improve transplant eligibility.
A total of 36 patients opted for weight loss procedures, 10 received a transplant and 15 were placed on a waitlist. Surgical teams shared resources, including dieticians, social workers and a common database to transition between teams, the researchers wrote.
Results showed a 27% reduction in average BMI at the time of transplant, coupled with enhanced management of hypertension and diabetes. Mean starting baseline BMI for was 46.4 kg/m2. It was 33.9 kg/ m2 at the time of transplant. The average number of hypertension medications decreased from two before surgery to one after surgery. Researchers also noted improvements in HbA1C, with preoperative levels averaging 6.2 and postoperative levels averaging 5.2. These outcomes bolstered patients’ overall health and suitability for transplant.
Study limitations included high drop-off rates of patients who were unwilling or unable to have surgery and postoperative complications such as hypotension, the researchers noted.
However, a “collaborative approach between bariatric and transplant surgery teams offers a pathway toward transplant for obese patients [with ESRD], and potentially alleviates existing health care disparities,” they wrote in the study.
Overall, the findings “indicate a pressing need to enhance patient education and support, making sure that potential candidates understand the benefits of weight loss surgery and its role in improving their eligibility for transplant,” Paramesh said.
References:
Patients with obesity and kidney failure may now qualify for kidney transplants. https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/press-releases/2024/patients-with-obesity-and-kidney-failure-may-be-newly-eligible-for-kidney-transplants/. Published Mar. 12, 2024. Accessed Mar. 12, 2024.
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