학술논문
Sleeve gastrectomy enables simultaneous pancreas and kidney transplantation in severely obese recipients.
Document Type
Article
Author
Source
Subject
*SLEEVE gastrectomy
*KIDNEY transplantation
*PANCREAS
*TYPE 1 diabetes
*BARIATRIC surgery
*KIDNEY exchange
*GINGIVAL grafts
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Language
ISSN
0902-0063
Abstract
Background: Obesity adversely affects wait‐listing and precludes patients with concomitant end‐stage renal disease and type 1 diabetes mellitus from getting a simultaneous pancreas and kidney transplantation (SPK). Objective: To analyze safety and efficacy of laparoscopic sleeve gastrectomy (LSG) before SPK in severely obese type I diabetics. Methods: We assessed weight curve, complications, and graft function of three patients who underwent LSG before SPK. Results: LSG was uneventful in all patients. Body mass index dropped from 38.4 (range 35.7 ‐ 39.9) before LSG to 28.5 (26.8 ‐ 30.9) until SPK, with a mean loss of 25.8% (22.4 ‐ 32.3). Interval between LSG and SPK was 364.3 (173 ‐ 587) days. Pancreas and kidney graft function was excellent, with 100% insulin‐free and dialysis‐free survival over a mean follow‐up of 3.6 (2.9 ‐ 4.5) years. A1C dropped from 7% (6.3 ‐ 8.2) before LSG to 4.9% (4.7 ‐ 5.3) and 4.8% (4.5 ‐ 5.1) 1 and 2 years after SPK, respectively. Conclusion: LSG before SPK is safe and effective to enable severely obese type I diabetics to receive a lifesaving transplant. This is the first study analyzing the role of bariatric surgery before simultaneous pancreas and kidney transplantation. [ABSTRACT FROM AUTHOR]