title: Combined Robot-assisted Kidney Transplantation and Sleeve Gastrectomy in a Morbidly Obese Recipient.
abstract: BACKGROUND
  Kidney transplantation confers a well-documented survival advantage for patients with end-stage renal disease (ESRD) over dialysis, regardless of body mass index (BMI). However, obese patients with ESRD have limited access to kidney transplantation. In most transplant centers, a patient with a BMI above 35 to 40 kg/m is either completely excluded from transplantation or is required to lose weight before being considered for transplantation.
  
  
  METHODS
  Herein, we present the first case of a 35-year-old woman with a BMI of 42 kg/m (96.8 kg) and ESRD, who underwent combined robot-assisted kidney transplant and sleeve gastrectomy.
  
  
  RESULTS
  The total operative time was 318 minutes with an estimated blood loss of 125 mL. At 24 months after transplantation, the patient's weight, BMI, creatinine, and estimated glomerular filtration rate were 81.9 kg, 35.1 kg/m, 0.79 mg/dL, and 81.2 mL/min per 1.73 m, respectively.
  
  
  CONCLUSIONS
  Combined robot-assisted kidney transplant and sleeve gastrectomy is feasible in morbidly obese patients and adds little additional operative time.
authors: 1 Division of Transplantation, University of Illinois Hospital & Health Sciences System, Chicago, IL.
authors: Subhashini M
authors: SM
authors: Ayloo
authors: Guiseppe
authors: G
authors: D'Amico
authors: Patricia
authors: P
authors: West-Thielke
authors: Lorena
authors: L
authors: Bejarano-Pineda
authors: Ivo
authors: I
authors: Tzvetanov
authors: Pier Cristoforo
authors: PC
authors: Giulianotti
authors: Enrico
authors: E
authors: Benedetti
authors: Jose
authors: J
authors: Oberholzer
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D002641:Chicago; D003404:Creatinine / Q000097:blood; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D009767:Obesity, Morbid / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D061646:Operative Time; D016032:Randomized Controlled Trials as Topic; D065287:Robotic Surgical Procedures; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D003404:Creatinine