Weight Loss Surgery Increases Kidney Transplant Rates in Patients With Renal Failure and Obesity

Area of Science:

• Nephrology
• Bariatric Surgery
• Transplant Surgery

Background:

• Obesity is a significant barrier for kidney transplant (KT) candidates.
• Sleeve gastrectomy (SG) is a bariatric procedure that can facilitate weight loss.
• Evaluating the outcomes of SG in KT candidates is essential for improving transplant eligibility.

Purpose of the Study:

• To assess the effectiveness of sleeve gastrectomy (SG) in kidney transplant (KT) candidates with obesity.
• To compare weight loss, adverse events, and transplant rates between SG and non-surgical cohorts.
• To determine the impact of SG on KT candidacy and outcomes.

Main Methods:

• Retrospective analysis of KT candidates with obesity (BMI >35 kg/m²).
• Comparison of patients who underwent SG versus a non-surgical cohort.
• Abstraction of weight loss, adverse health events, and transplant listing and reception rates.

Main Results:

• SG significantly reduced body mass index (BMI) at 2 and 12 months post-surgery.
• The SG group had higher rates of active listing (37/54) and KT reception (20/54) compared to the non-surgical group (14/50 listed, 5/50 received KT).
• While overall adverse events were similar, the SG cohort had a higher risk of functional decline.

Conclusions:

• Sleeve gastrectomy is effective in facilitating kidney transplantation for candidates with obesity.
• A significant percentage (37%) of patients undergoing SG received a KT within 18 months.
• Further research is needed to optimize the safety and efficacy of SG in this patient population.