title: Laparoscopic Sleeve Gastrectomy in Kidney Transplant Candidates: a Case Series.
abstract: Patients with a body mass index (BMI) >35 kg/m2who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list. The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant.
  
  
  
  This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France). All the patients were contraindicated for kidney transplantation due to the presence of morbid obesity.
  
  
  
  Nine DDFR patients with a mean BMI of 45.9 kg/m2underwent LSG for the treatment of obesity. Furthermore, all patients presented with hypertension and sleep apnea and six out nine were diabetics. In the immediate postoperative period, all patients were transferred to the intensive care unit (mean stay of 2.1 days). The only major adverse event was a delayed weaning from mechanical ventilation in one patient. The mean hospital stay was 5.5 days (3-12). The total weight loss (TWL) was 27.1, 33.6, and 39.5 kg at 6, 12, and 18 months, respectively. One patient underwent renal transplantation 18 months after LSG, and the other five patients were actively listed for kidney transplantation.
  
  
  
  According to the results of this small sample series, LSG seems to be an effective and safe procedure in DDRF patients with concomitant obesity and can increase access to transplantation.
authors.affiliation: Department of Digestive and Metabolic Surgery, Avicenne University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre Intégré Nord Francilien de la prise en charge de l'Obésité (CINFO), Université Paris XIII-UFR SMBH "Léonard de Vinci", AP-HP, route de Stalingrad, Bobigny, France. sergio.carandina@gmail.com.|Department of Digestive and Bariatric Surgery, Clinique Saint Michel, 4, Place du 4 Septembre, 83100, Toulon, France. sergio.carandina@gmail.com.
authors.forename: Sergio
authors.identifier: http://orcid.org/0000-0003-0651-5606
authors.initials: S
authors.lastname: Carandina
authors.affiliation: Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver Transplantation, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Pierre & Marie Curie University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Genser
authors.affiliation: Department of Digestive and Metabolic Surgery, Avicenne University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre Intégré Nord Francilien de la prise en charge de l'Obésité (CINFO), Université Paris XIII-UFR SMBH "Léonard de Vinci", AP-HP, route de Stalingrad, Bobigny, France.
authors.forename: Manuela
authors.initials: M
authors.lastname: Bossi
authors.affiliation: Department of Digestive and Metabolic Surgery, Avicenne University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre Intégré Nord Francilien de la prise en charge de l'Obésité (CINFO), Université Paris XIII-UFR SMBH "Léonard de Vinci", AP-HP, route de Stalingrad, Bobigny, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Montana
authors.affiliation: Department of Digestive and Metabolic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre Hospitalier Marne-la-Vallée, 77600, Jossigny, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Cortes
authors.affiliation: Department of Digestive and Metabolic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre Hospitalier Marne-la-Vallée, 77600, Jossigny, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Seman
authors.affiliation: Department of Digestive and Bariatric Surgery, Clinique Saint Michel, 4, Place du 4 Septembre, 83100, Toulon, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Danan
authors.affiliation: Department of Digestive and Metabolic Surgery, Avicenne University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre Intégré Nord Francilien de la prise en charge de l'Obésité (CINFO), Université Paris XIII-UFR SMBH "Léonard de Vinci", AP-HP, route de Stalingrad, Bobigny, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Barrat
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D010297:Paris; D051437:Renal Insufficiency / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D066027:Transplant Recipients; D016896:Treatment Outcome; D014850:Waiting Lists; D015431:Weight Loss / Q000502:physiology
keywords: Kidney transplant; Laparoscopic sleeve gastrectomy; Renal failure; Transplantation waiting list