Outcomes of Bariatric Surgery Before, During, and After Solid Organ Transplantation.

Abstract

Bariatric surgery (BS) may help transplant patients by improving their comorbidities and graft function and reducing the recurrence of the disease that led to the transplant. Different timings for BS have been proposed. This study aims to describe the outcomes of BS before, during, and after solid organ transplantation. We identified patients with history of solid organ transplantation that underwent BS between January 1, 2012, and April 31, 2022, at our hospital site. We analyzed patients' demographics, obesity-related comorbidities, and transplant history. Measured outcomes included post-operative morbidity; readmission; comorbidity management; weight loss at 6-, 12-, and 24-month follow-up; and survival. Seventy-eight patients were included in our analysis, with a median age of 57 (28-75) years and a median BMI of 40.91 (28.9-61) kg/m2. The most transplanted organ was the liver (53.6%), followed by the kidney (31.9%). Ten patients underwent BS before the transplant, 11 had simultaneous BS and liver transplant, and 57 underwent BS after the transplant. The median operative time, ICU requirement, length of hospital stay, and early post-operative complications were significantly higher in the simultaneous group. The median EBWL% at 6-, 12-, and 24-month follow-up was 47.51%, 57.89%, and 64.22%, respectively, with no significant difference between the three groups. Thirty-four (44.3%) and 40 (50.8%) patients reduced their HTN and DM medication dosage, respectively. One- and five-year survival rates were 98.2% and 87.4%. BS before, during, or after solid organ transplant is safe, leads to a significant weight loss and improvement of obesity-related comorbidities, and improves patient's survival.