Bariatric Surgery as a Bridge to a Successful Kidney Transplantation: A Case Report

• Published in: Transplantation proceedings 2024-06, Vol.56 (5), p.1142-1147
• Main Authors: Uesato, Yasunori, Inamine, Susumu
• Format: Article
• Language: English
• Subjects: Bariatric Surgery; Gastrectomy; Humans; Kidney Failure, Chronic - surgery; Kidney Transplantation; Laparoscopy; Living Donors; Male; Obesity, Morbid - complications; Obesity, Morbid - surgery; Treatment Outcome
• ISSN: 0041-1345; 1873-2623; 1873-2623
• DOI: 10.1016/j.transproceed.2024.05.010

•Bariatric surgery before kidney transplant improves outcomes in obese patients.•Laparoscopic sleeve gastrectomy enables successful kidney transplantation.•Post-surgery, patient weaned off dialysis with improved renal function. Severe obesity impairs renal function and outcomes in kidney transplant recipients. Bariatric surgery benefits those unresponsive to medical treatments. Limited case reports exist on its efficacy and long-term prognosis for transplant candidates. Thus, this study aims to present a case in which laparoscopic sleeve gastrectomy was safely performed on a patient with severe obesity awaiting kidney transplantation. This study included a dialysis patient with a body mass index of 47 kg/m2. Living-donor kidney transplantation using his younger sister as a donor was considered, but it was determined that the risk of complications during and after surgery was high. Medical treatment was first performed, but the obesity did not improve; therefore, a laparoscopic sleeve gastrectomy was performed. Although postoperative bleeding occurred, the patient was discharged from the hospital on the 14th postoperative day. Subsequently, his weight steadily decreased, and living-donor kidney transplantation was performed 13 months after laparoscopic sleeve gastrectomy was performed. Furthermore, the patient's progress after kidney transplantation was good, and he was freed from hemodialysis. Improving severe obesity before kidney transplantation is effective in improving prognosis, and bariatric surgery should be considered when medical treatment is ineffective. Future research are needed to determine the optimal time between the performance of this procedure and kidney transplantation, as well as the long-term prognosis after kidney transplantation.