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      Bariatric surgery among kidney transplant candidates and recipients: analysis of the United States renal data system and literature review.

      Transplantation

      Weight Loss, United States, Survivors, Survival Rate, Safety, Registries, epidemiology, Postoperative Complications, surgery, complications, Obesity, Morbid, Morbidity, Middle Aged, Male, statistics & numerical data, Kidney Transplantation, Kidney Failure, Chronic, Humans, methods, Gastroplasty, Gastric Bypass, Female, Body Mass Index, mortality, Bariatric Surgery, Adult

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          Abstract

          Limited data exist on the safety and efficacy of bariatric surgery (BS) in patients with kidney failure. We examined Medicare billing claims within USRDS registry data (1991-2004) to identify BS cases among renal allograft candidates and recipients. Of 188 BS cases, 72 were performed pre-listing, 29 on the waitlist, and 87 post-transplant. Roux-en-Y gastric bypass was the most common procedure. Thirty-day mortality after BS performed on the waitlist and post-transplant was 3.5%, and one transplant recipient lost their graft within 30 days after BS. BMI data were available for a subset and suggested median excess body weight loss of 31%-61%. Comparison to published clinical trials of BS in populations without kidney disease indicates comparable weight loss but higher post-BS mortality in the USRDS sample. Given the substantial contributions of obesity to excess morbidity and mortality, BS warrants prospective study as a strategy for improving outcomes before and after kidney transplantation.

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          Author and article information

          Journal
          19384163
          2833328
          10.1097/TP.0b013e31819e3f14

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