Sleeve gastrectomy may be effective for adults with obesity awaiting kidney transplant
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Key takeaways:
- During 15.5 months, 37 of 54 patients with sleeve gastrectomy group were listed for transplant.
- Overall, 20 of 54 patients with sleeve gastrectomy had a kidney within a median 20.9 months.
Sleeve gastrectomy may be an effective option for adults with obesity who are kidney transplant candidates, according to a published data.
“Of the weight loss surgeries, laparoscopic sleeve gastrectomy (SG) has been the most commonly performed procedure in patients seeking [kidney transplant] KT,” Aleksandra Kukla, MD, a transplant nephrologist at Mayo Clinic, wrote with colleagues. “It has been reported to be effective in inducing rapid weight loss, reducing obesity-related comorbidities, and improving access to KT; however, safety concerns remain.”
Researchers of the retrospective analysis evaluated records of 104 candidates for kidney transplant, who also had obesity, to determine the effectiveness of undergoing sleeve gastrectomy to enhance transplant eligibility. Obesity was defined as a BMI greater than 35 kg/m2.
Overall, 54 patients had sleeve gastrectomy at the institution and 50 patients did not have the procedure. Researchers compared weight loss, adverse health events and listing and transplant rates between the two groups.
Each group of patients had similar baseline demographic traits, with the sleeve gastrectomy group having a mean baseline BMI of 41.7 kg/m2. Following 2 months and 12 months post-sleeve gastrectomy, mean BMI decreased to 36.4 kg/m2 and 32.6 kg/m2, respectively.
During a median follow-up of 15.5 months, 37 of 54 patients in the sleeve gastrectomy group were actively listed for transplant and 20 of 54 patients received a kidney within a median of 20.9 months. Researchers also found 14 of 50 patients in the nonsurgical cohort were listed and five received a transplant. Three patients had surgical complications.
Earlier research found “conservative weight-loss approaches do not adequately result in significant weight loss in patients with advanced chronic kidney disease,” Kukla said in a press release. “These new findings support the value of surgical gastrectomy for patients with advanced chronic kidney failure, stage 4-5D, to improve general health and access to kidney transplantation.”
Researchers found no significant difference in hospitalization rates and adverse health outcomes but noted higher risk of clinically significant functional decline in the sleeve gastrectomy cohort.
“Further research is needed to confirm and to improve the safety and efficacy of SG for patients with obesity seeking a KT,” they wrote in the study.
Reference:
Weight-loss surgery before kidney transplantation improves health and eligibility of patients with obesity and renal failure, Mayo Clinic study finds. https://newsnetwork.mayoclinic.org/discussion/weight-loss-surgery-before-kidney-transplantation-improves-health-and-eligibility-of-patients-with-obesity-and-renal-failure-mayo-clinic-study-finds/#:~:text=%E2%80%94%20Laparoscopic%20sleeve%20gastrectomy%20promotes%20relatively,new%20research%20from%20Mayo%20Clinic. Published May 2, 2024. Accessed May 9, 2023.
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