title: Bariatric surgery among kidney transplant candidates and recipients: analysis of the United States renal data system and literature review.
abstract: BACKGROUND
  Limited data exist on the safety and efficacy of bariatric surgery (BS) in patients with kidney failure.
  
  
  METHODS
  We examined Medicare billing claims within USRDS registry data (1991-2004) to identify BS cases among renal allograft candidates and recipients.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Abdominal Organ Transplantation, Department of Surgery, Saint Louis University Medical Center, St. Louis, MO 63130, USA.
authors.forename: Kian A
authors.initials: KA
authors.lastname: Modanlou
authors.forename: Umadevi
authors.initials: U
authors.lastname: Muthyala
authors.forename: Huiling
authors.initials: H
authors.lastname: Xiao
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schnitzler
authors.forename: Paolo R
authors.initials: PR
authors.lastname: Salvalaggio
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Abbott
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Graff
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lentine
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000401:mortality / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012042:Registries; D012449:Safety; D015996:Survival Rate; D017741:Survivors; D014481:United States; D015431:Weight Loss