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31 March 2012

Bariatric surgery as a bridge for kidney transplantation in obese subjects. Case report

Rafał MarszałekABCDEF, Paweł ZiemiańskiABCDEF, Wojciech LisikABCDEF, Zbigniew WierzbickiBD, Justyna Domienik-KarłowiczABC, Janusz TrzebickiBC, Artur KwiatkowskiBC, Dariusz WasiakBC, Piotr PruszczykCD, Leszek PączekCD, Andrzej ChmuraADEF

DOI: 10.12659/AOT.882642

Ann Transplant 2012; 17(1): 108-112

Abstract

Background: The epidemiological studies indicate that the problem of obesity and associated metabolic syndrome affects the steadily increasing population. The obesity also applies to the patients with the end-stage renal failure requiring renal replacement therapy. Morbid obesity is a contraindication to renal transplantation procedure. A significant excess weight greatly increases the waiting time for transplantation, increases the risk of surgical complications, including complications due to cardiovascular and metabolic disorders. The combination of these risk factors with the immunosuppressive therapy may worsen the symptoms associated with the renal failure, contribute to the deterioration of graft function, shorten the survival, and increase the risk of patient death.
Case Report: In this paper we described the first Polish case of kidney transplantation, in a patient after bariatric surgery. The patient was disqualified from kidney transplantation because of obesity and referred to our department for metabolic surgery and weight reduction before potential kidney transplantation. 10 months post the bariatric surgery patient was selected as a kidney transplant recipient from a deceased donor. Both procedures have been performed in this same center.
Conclusions: Bariatric surgery procedures are safe and effective in patients with end-stage renal disease. Bariatric procedures may be considered as a procedural bridge for a group of morbidly obese patients with renal failure, allowing them to be qualified for transplantation.

Keywords: Bariatric Surgery, metabolic syndrome, end-stage renal disease, Renal Replacement Therapy, Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358