title: Bariatric Surgery in Renal Transplant Patients.
abstract: OBJECTIVE
  The idea of transplanting organs is not new, nor is the disease of obesity. Obese transplant recipients have greater risk of early death than their cohorts, which is not due to increased rejection but due to obesity-related complications, including arterial hypertension, diabetes, and delayed graft function. Here, our aim was to evaluate the effects of bariatric surgery versus lifestyle changes on outcomes of moderate to severely obese renal transplant recipients.
  
  
  METHODS
  Twenty-two morbidly obese patients with stable graft function who underwent bariatric surgery were compared with 44 obese patients on lifestyle management (control group). Both groups were evaluated regarding graft and patient outcomes.
  
  
  RESULTS
  The studied groups were comparable demographically. In the bariatric study group versus control group, we observed that the mean body mass index was 38.49 ± 9.1 versus 44.24 ± 6 (P = .024) at transplant and 34.34 ± 7.6 versus 44.38 ± 6.7 (P = .002) at 6 months of bariatric surgery. Both groups received a more potent induction immunosuppression, but this was significantly higher in the obese nonbariatric control group (P < .05). There were more patients with slow and delayed graft functions in the same nonbariatric group. The 2 groups were comparable regarding new-onset diabetes after transplant, total patients with diabetes, and graft outcomes (P > .05).
  
  
  CONCLUSIONS
  Bariatric surgeries are feasible, safe pro cedures for selected obese renal transplant recipients.
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt; the Nephrology Department, Hamed Al-Essa Organ Transplant Center, Sabah Area, Kuwait.
authors.forename: Osama
authors.initials: O
authors.lastname: Gheith
authors.forename: Torki
authors.initials: T
authors.lastname: Al-Otaibi
authors.forename: Medhat A
authors.initials: MA
authors.lastname: Halim
authors.forename: Tarek
authors.initials: T
authors.lastname: Mahmoud
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mosaad
authors.forename: Jude
authors.initials: J
authors.lastname: Yagan
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Zakaria
authors.forename: Suzann
authors.initials: S
authors.lastname: Rida
authors.forename: Prasad
authors.initials: P
authors.lastname: Nair
authors.forename: Rashad
authors.initials: R
authors.lastname: Hassan
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects; D015992:Body Mass Index; D016022:Case-Control Studies; D051799:Delayed Graft Function / Q000209:etiology; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents