title: Kidney transplantation and gastric bypass: a better control of comorbidities.
abstract: The database of patients who underwent laparoscopic gastric bypass at our institution from 2002 to 2008 was reviewed. Five patients with kidney transplants were found. The impact of the laparoscopic gastric bypass on their comorbidities and the grafts and patients' survival were studied. The five patients of the group are between 36 and 66 years old, three men and two women. Preoperative body mass index ranged between 35 and 42 kg/m(2). The first patient was operated on 4 years ago and presented an anastomotic leak at the gastrojejunal anastomosis that healed with medical treatment. The remaining four patients did not present postoperative complications. At the moment of analysis, the five patients were healthy and enjoying a good quality of life. All the patients had dyslipidemia which reached normal levels after surgery. Three of the patients had diabetes and achieved good control after the surgery. Most importantly, the absorption of immune suppressors was not altered; while some of the patients were even able to reduce their doses. Patients with renal terminal renal diseases and those with renal transplants with severe or morbid obesity are a group that can particularly benefit from a gastric bypass. The laparoscopic gastric bypass is feasible in severely or morbidly obese patients with kidney transplantation. The absorption of the immune-suppressive medication is not altered after a gastric bypass.
authors.affiliation: Surgeon Obesity Clinic, Fundación Valle del Lili, Cali, Colombia. rahu1@yahoo.com
authors.forename: Rafael H
authors.initials: RH
authors.lastname: Arias
authors.forename: Liliana
authors.initials: L
authors.lastname: Mesa
authors.forename: Juan Guillermo
authors.initials: JG
authors.lastname: Posada
authors.forename: José Pablo
authors.initials: JP
authors.lastname: Vélez
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003105:Colombia / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D051437:Renal Insufficiency / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome; D015431:Weight Loss