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Bariatric surgery prior to living donor nephrectomy: a solution to expand the living donor kidney pool.

07:00 EST 5th February 2019 | BioPortfolio

Summary of "Bariatric surgery prior to living donor nephrectomy: a solution to expand the living donor kidney pool."

Most transplant centers decline morbidly obese people for living kidney donation. Their inclusion in the living donor pool after weight loss and reversal of comorbidities by bariatric surgery could reverse the downward living donation trend. We investigated whether bariatric surgery in the morbidly obese altered their candidacy for donation, complicated their subsequent donor nephrectomy, and impacted their early post-operative outcomes in a series of 22 donors who had bariatric surgery 0.7 - 22 years prior to laparoscopic living donor nephrectomy. 18 would have been excluded from donation prior to bariatric surgery based on a BMI > 40. 17 reached a BMI < 35 after bariatric surgery. 1 had hypertension that resolved after bariatric surgery. Prior bariatric surgery did not influence port placement and laterality of donor nephrectomy. None required open conversion or blood transfusion. In an exploratory comparison with 37 donors with a BMI 35 - 40, length of stay and warm ischemic time were shorter, blood loss and post-operative complications were similar, and operative time was longer. We therefore advocate the consideration of bariatric surgery in preparation for donation in morbidly obese people since it positively alters their candidacy without major impact on the subsequent living donor nephrectomy and early outcomes. This article is protected by copyright. All rights reserved.

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This article was published in the following journal.

Name: Transplant international : official journal of the European Society for Organ Transplantation
ISSN: 1432-2277
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