Feasibility and outcomes of laparoscopic sleeve gastrectomy after solid organ transplantation

Khoraki, Jad; Katz, Micah G.; Funk, Luke M.; Greenberg, Jacob A.; Fernández, Luis A.; Campos, Guilherme M.

doi:10.1016/j.soard.2015.04.002

Cited by 58 publications

(41 citation statements)

References 44 publications

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“…One of the aspects evaluated was the immunosuppressive medications. At the one-yr follow-up, six patients were on the same immunosuppressive regimen as the regimen used before surgery, three were taking lower dosages of medications, and only one patient was taking higher doses (12). Similar results were also obtained by Lin et al (13).…”

Section: Discussionsupporting

confidence: 78%

Simultaneous or sequential gastrectomy in pediatric liver transplant recipients

Roda

Fonseca

Cândido

et al. 2016

Pediatric Transplantation

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The association between LT and gastrectomy is not common. Only two studies reported the gastrectomy/LT association in children. Here, we report three children who underwent LT who required a concomitant or sequential gastrectomy for different reasons. Patient 1, a 16-yr-old boy, during the LT, underwent a partial gastrectomy due to extensive injury to the duodenum. He had a previous and unusual portoenterostomy performed in the duodenum. Bowel reconstruction was performed using an intestinal loop that was first used for the bilio-enteric anastomosis and then connected to the gastric stump. Patient 2, a 22-month-old female child, underwent a partial gastrectomy with a Roux-en-Y reconstruction during a retransplantation. She had a large perforated gastric ulcer blocked by the allograft liver. Patient 3, a 26-month-old male child, five yr after living donor LT, was submitted to a partial gastrectomy because of gastric outlet obstruction. The histopathology was compatible with eosinophilic gastritis. The association between LT and gastrectomy in the pediatric population is extremely rare. Appropriate knowledge of the previous transplantation technique is very important. Further studies are required to assess the outcomes of the different types of gastric reconstruction in pediatric recipients.

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Section: Discussionsupporting

confidence: 78%

Simultaneous or sequential gastrectomy in pediatric liver transplant recipients

Roda

Fonseca

Cândido

et al. 2016

Pediatric Transplantation

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“…These findings are comparable to %EWL seen in the nontransplant population that range from 53.3% in LSG and 62.6% in RYGB . In the post‐LT population, %EWL ranges from 43% to 76% in studies with a minimum of 12‐month follow‐up . In a recent series of 12 patients who underwent LSG following LT, Tsamalaidze et al demonstrated a change in BMI similar to a matched non‐LT cohort and a %EWL of 50% at 1 year .…”

Section: Discussionmentioning

confidence: 52%

“…Operating on this complex patient population is not without risks, and the complication rate has been cited as up to 40%. These complications include infection, staple line leaks, reoperation, and even death . In the previously largest study of LSG after LT, Tsamalaidze et al observed a major complication rate of 25% and no reoperations or deaths .…”

Section: Discussionmentioning

confidence: 99%

Delayed Sleeve Gastrectomy Following Liver Transplantation: A 5‐Year Experience

et al. 2019

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Obesity has become an epidemic in the United States over the past decade, and recent studies have shown this trend in the liver transplantation (LT) population. These patients may be candidates for laparoscopic sleeve gastrectomy (LSG) to promote significant and sustained weight loss to prevent recurrence of nonalcoholic steatohepatitis. However, safety remains a concern, and efficacy in this setting is uncertain. A single‐institution database from 2014 to 2018 was queried for patients undergoing LSG following LT. The selection criteria for surgery were consistent with National Institutes of Health guidelines, and patients were at least 6 months after LT. A total of 15 patients (median age, 59.0 years; Caucasian, 86.7%; and female, 60%) underwent LSG following LT. Median time from LT to LSG was 2.2 years with a median follow‐up period of 2.6 years. The median hospital length of stay (LOS) was 2 days after LSG. Mortality and rate of liver allograft rejection was 0, and there was 1 postoperative complication (a surgical site infection). Following LSG, body mass index (BMI) decreased from 42.7 to 35.9 kg/m2 (P < 0.01), and in 12 patients with at least 1 year of follow‐up, the total body weight loss was 20.6%. Following LSG in patients with diabetes, the median daily insulin requirements decreased from 98 (49‐118) to 0 (0‐29) units/day (P = 0.02), and 60% discontinued insulin. Post‐LT patients had a similar decrease in BMI and reduction in comorbidities at 1 year compared with a matched non‐LT patient cohort. In the largest patient series to date, we show that LSG following LT is safe, effective, and does not increase the incidence of liver allograft rejection. Larger longer‐term studies are needed to confirm underlying metabolic changes following LSG.

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“…It is considered a non-complex procedure compared to gastric bypass. Therefore, these advantages are of the greatest value for patients who are primarily liable to the incidence of complications [19][20][21][22][23][24][25][26].…”

Section: Resultsmentioning

confidence: 99%

Feasibility and impact of laparoscopic sleeve gastrectomy after renal transplantation on comorbidities, graft function and quality of life.

Alenazi

Ahmad

Elsamahy

et al. 2020

Preprint

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Background: The aim of this study is to clarify the feasibility and effect of laparoscopic sleeve gastrectomy (LSG) on comorbidities, graft function and quality of life in patients who underwent renal transplantation (RT) Methods: This is a retrospective review of 5 patients who underwent LSG after RT. Demographic data, anthropometric parameters, the effect on comorbidities, postoperative course, immunosuppressive medications, causes of RT, renal function, the survival of graft, and quality of life after SG in obese patients with a history of RT were assessed using BAROS–Moorhead–Ardelt survey Results From September 2015 to September 2019, 5 renal transplant patients underwent LSG; 60% were female, and 40 were male. Median body mass index (BMI) decreased from 42.17 kg/m2 (range 36–55) before surgery to 28.16 kg/m2 (range 25–42) after surgery. Improvement in blood pressure, triglyceride, and cholesterol levels was observed, and all cases were able to decrease their medications. Insulin was stopped and replaced with linagliptin in all diabetic patients. Graft function improved, and proteinuria level decreased in all cases (100%). All patients reported to have an excellent quality of life.Conclusion: LSG showed excellent outcomes in this high-risk group of patients regarding comorbidities, graft function and quality of life

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Feasibility and outcomes of laparoscopic sleeve gastrectomy after solid organ transplantation

Cited by 58 publications

References 44 publications

Simultaneous or sequential gastrectomy in pediatric liver transplant recipients

Simultaneous or sequential gastrectomy in pediatric liver transplant recipients

Delayed Sleeve Gastrectomy Following Liver Transplantation: A 5‐Year Experience

Feasibility and impact of laparoscopic sleeve gastrectomy after renal transplantation on comorbidities, graft function and quality of life.

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