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Laparoscopic gastric banding after heart transplantation
B Ablassmaier1, S Klaua, C A Jacobi
1Outpatient Clinic of Internal Medicine, Humboldt University, Berlin, Germany.
Background:
Obesity often complicates the postoperative course of heart transplant recipients. Laparoscopic adjustable gastric banding (LAGB) represents a minimal invasive therapeutic possibility for weight reduction in non-transplanted patients.
Case Report:
We report a 55-year-old diabetic, morbidly obese male (weight 138 kg, height 173 m, BMI 46 kg/m2) in whom 6 years after orthotopic heart transplantation, LAGB and laparoscopic cholecystectomy were successfully performed. At follow-up of 28 months, the patient has lost 32 kg. His present weight is 106 kg (BMI 35.4). Diabetes improved, and oral diabetic medication was withdrawn. Cyclosporine dosage has not had to be changed after LAGB.
Conclusion:
In morbidly obese transplanted patients, LAGB should be considered as an effective alternative to dietetic measures to enable weight reduction and to improve comorbidities. In contrast to bariatric malabsorption techniques, like jejunoileal bypass and gastric bypass, cyclosporine pharmacokinetics do not appear to be influenced by gastric banding.