title: Sleeve gastrectomy surgery in obese patients post-organ transplantation.
abstract: BACKGROUND
  Among organ transplant recipients, a common side effect of immunosuppressive therapy is the development of obesity, which affects a third of the patients within 3 years after transplantation. Bariatric surgery represents a possible surgical option for weight loss among posttransplant patients.
  
  
  OBJECTIVE
  The aim of this study was to examine percent excess weight loss (%EWL), and percent weight loss (%WL) and perioperative and postoperative complications in posttransplant obese patients after sleeve gastrectomy (SG) compared with nontransplant patients. We hypothesize that transplant patients who undergo SG will not significantly differ in their perioperative or postoperative complications or in their %EWL and %WL compared with nontransplant patients who undergo SG. The second aim was to evaluate the impact of SG on graft function and immunosuppressive therapy in transplant patients.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Among 500 consecutive patients who underwent SG from January 2008 to June 2014, 10 patients were organ transplant recipients. The following variables were compared between groups: patient demographic characteristics and co-morbidities, type of transplant surgery, date of transplant surgery, pretransplant body mass index (BMI), date of bariatric surgery, prebariatric surgery BMI, operative time, length of hospitalization, postoperative complications, and change in BMI, %EWL, and %WL. Data were also collected on renal, liver, and pancreas graft function parameters and changes in immunosuppressive medications.
  
  
  RESULTS
  Six patients had a kidney transplant, 2 patients had a liver transplant, and 2 had a pancreas transplant. No significant differences were observed in %EWL or %WL at 6 and 12 months follow-up between transplant and nontransplant patients. No transplant patients were lost to follow-up at 6 and 12 months. Among nontransplant patients, 36.7% and 35.7% were lost to follow-up at 6 and 12 months, respectively. No postoperative complications were registered in the transplant group. SG did not negatively affect the graft function.
  
  
  CONCLUSIONS
  Initials results found that there were no significant differences in %EWL or %WL at 6 and 12 months follow-up between transplant and nontransplant patients. There were also no perioperative and postoperative complications among transplant patients after SG.
authors.affiliation: University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Elli
authors.affiliation: University of Illinois at Chicago College of Medicine, Chicago, Illinois. Electronic address: rgheredi@uic.edu.
authors.forename: Raquel
authors.initials: R
authors.lastname: Gonzalez-Heredia
authors.affiliation: University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Lisa
authors.initials: L
authors.lastname: Sanchez-Johnsen
authors.affiliation: University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Neil
authors.initials: N
authors.lastname: Patel
authors.affiliation: University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia-Roca
authors.affiliation: University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Jose
authors.initials: J
authors.lastname: Oberholzer
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007430:Intraoperative Care / Q000379:methods; D016030:Kidney Transplantation / Q000379:methods; D007902:Length of Stay; D016031:Liver Transplantation / Q000379:methods; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D016035:Pancreas Transplantation / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods; D066027:Transplant Recipients; D015431:Weight Loss / Q000502:physiology
chemical_list: D007166:Immunosuppressive Agents
keywords: Immunosuppressive treatment; Morbid obesity; Organ transplantation; Sleeve gastrectomy