Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

08 December 2014 : Case report  

Improvement of Graft Function following Roux-en-Y Gastric Bypass Surgery in a Morbidly Obese Kidney Recipient: A Case Report and Literature Review

Paweł ZiemiańskiAB, Wojciech LisikACDEF, Rafał J. MarszałekAB, Tomasz CieciuraBF, Justyna Domienik-KarłowiczDE, Janusz TrzebickiDE, Tomasz GryczewskiBC, Zbigniew WierzbickiDF, Maciej KosieradzkiDF, Magdalena DurlikDG, Piotr PruszczykDG, Andrzej ChmuraDG

DOI: 10.12659/AOT.892954

Ann Transplant 2014; 19:639-642

Abstract

BACKGROUND: Transplantation is the best and approved method of renal replacement therapy. Graft function depends not only on proper regulation of immune processes but also on the optimal control of chronic diseases. The obesity epidemic involves the healthy population and organ recipients equally. Obesity and metabolic syndrome lead to a number of disorders exerting adverse effects on the transplanted organ.

CASE REPORT: We report a case of a kidney recipient, 12 years after transplantation, with chronic graft failure (serum creatinine level 2.1 mg/dl, GFR 31 ml/min/1.73 m2), morbid obesity (weight 139.8 kg, BMI 46.2 kg/m2, excess body mass 73.1 kg), hypertension, poorly controlled type 1 diabetes (HbA1c 8.8%), and ischemic heart disease. The cause of chronic kidney disease was diabetic nephropathy. The patient was the first Polish kidney recipient referred for bariatric gastric bypass surgery (GB). Directly after surgery, transient creatinine elevation (4.7 mg/dl) was noted. There was no reduction in diuresis. Desired weight loss was achieved within 12 months after surgery (body mass 81.9, BMI 27.1 kg/m2, percentage loss of excess weight 86.9%) with improved graft function (serum creatinine level 1.3 mg/dl, GFR 45.1 ml/min/1.73 m2) and reduction of daily insulin requirement from 74 to 40 units. The severity of hypertension and ischemic heart disease diminished as well.

CONCLUSIONS: Metabolic surgery is the best treatment of obesity and may contribute to post-transplantation care if weight gain is observed, as a result of the interaction of many factors leading to deterioration of renal graft function.

Keywords: Bariatric Surgery, Kidney Transplantation, Metabolic Syndrome X

Add Comment 0 Comments

In Press

Original article  

Biopsychosocial Effects of Donor Traits on Heart Transplant Recipients

Ann Transplant In Press; DOI:  

Clinical Research  

Ten-Year Retrospective Analysis of Continuous Renal Replacement Therapy in Burn Patients: Impact on Surviva...

Ann Transplant In Press; DOI:  

Original article  

Factors Influencing Stress Disorders in Intensive Care Unit (ICU) Patients After Liver Transplantation: A C...

Ann Transplant In Press; DOI: 10.12659/AOT.944320  

Original article  

Hepatopulmonary Syndrome and Liver Transplantation: Impact on Survival and Postoperative Complications

Ann Transplant In Press; DOI: 10.12659/AOT.945297  

Most Viewed Current Articles

05 Apr 2022 : Original article   13,115

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

22 Nov 2022 : Original article   10,262

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

12 Jan 2022 : Original article   9,616

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

15 Mar 2022 : Case report   7,277

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

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