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Renal transplant bariatric

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https://www.readbyqxmd.com/read/27410399/recurrence-of-hyperoxaluria-and-kidney-disease-after-combined-intestine-kidney-transplantation-for-enteric-hyperoxaluria
#1
Burcin Ekser, Richard S Mangus, Chandrashekhar A Kubal, Jonathan A Fridell, John A Powelson, Santosh Nagaraju, Plamen Mihaylov, Carrie L Phillips, Romil Saxena, William C Goggins
BACKGROUND: Enteric hyperoxaluria (EH) occurs with a rate of 5-24% in patients with inflammatory bowel disease, ileal resection and modern bariatric surgery. The excessive absorption of calcium oxalate causes chronic kidney disease (CKD) in patients with EH. In the literature, a single experience was reported in combined intestine-kidney transplantation (CIKTx) in patients with CKD due to EH. METHODS: After a report of 2 successful cases of CIKTx in patients with EH and CKD, one was performed at our center in a 59-year-old Caucasian female who developed intestinal failure with total parenteral nutrition (TPN) dependence after a complication post-bariatric surgery...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27234772/successful-management-of-new-onset-diabetes-mellitus-and-obesity-with-the-use-of-laparoscopic-sleeve-gastrectomy-after-kidney-transplantation-a-case-report
#2
J-H Chen, C-H Lee, C-M Chang, W-Y Yin
In kidney transplantation, obesity is associated with poorer graft survival and patient survival. Bariatric surgery may provide benefit for these patients, not only by inducing weight loss, but also via reduction of diabetes. We report a case of morbid obesity, poorly controlled new-onset diabetes mellitus, and gout after kidney transplantation that was treated with laparoscopic sleeve gastrectomy 3 years after kidney transplantation. After 1 year of follow-up, 76% excessive body weight loss was attained. No complications were noted...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/26941053/is-bariatric-surgery-in-patients-following-renal-transplantation-safe-and-effective-a-best-evidence-topic
#3
Nancy Hadjievangelou, Myutan Kulendran, Emma Rose McGlone, Marcus Reddy, Omar A Khan
Obesity is common amongst patients with renal transplants (RT). It is associated not only with generic obesity-related complications including diabetes, but also with higher rates of graft rejection and loss. A Best Evidence Topic in surgery was written according to a structured protocol: this is a systematic review of the literature, suitable when the quality of available evidence is low. The question addressed was: is weight-loss surgery (WLS) safe and effective in patients that have had a previous renal transplant? Three prospective case series and one multicentre retrospective study were identified, together reporting on a total of 112 patients who underwent WLS after RT...
April 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/26823089/sleeve-gastrectomy-surgery-in-obese-patients-post-organ-transplantation
#4
Enrique F Elli, Raquel Gonzalez-Heredia, Lisa Sanchez-Johnsen, Neil Patel, Raquel Garcia-Roca, Jose Oberholzer
BACKGROUND: Among organ transplant recipients, a common side effect of immunosuppressive therapy is the development of obesity, which affects a third of the patients within 3 years after transplantation. Bariatric surgery represents a possible surgical option for weight loss among posttransplant patients. OBJECTIVES: The aim of this study was to examine percent excess weight loss (%EWL), and percent weight loss (%WL) and perioperative and postoperative complications in posttransplant obese patients after sleeve gastrectomy (SG) compared with nontransplant patients...
March 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/26787788/role-of-cardiopulmonary-exercise-testing-as-a-risk-assessment-method-in-patients-undergoing-intra-abdominal-surgery-a-systematic-review
#5
REVIEW
J Moran, F Wilson, E Guinan, P McCormick, J Hussey, J Moriarty
BACKGROUND: Cardiopulmonary exercise testing (CPET) is used as a preoperative risk-stratification tool for patients undergoing non-cardiopulmonary intra-abdominal surgery. Previous studies indicate that CPET may be beneficial, but research is needed to quantify CPET values protective against poor postoperative outcome [mortality, morbidity, and length of stay (LOS)]. METHODS: This systematic review aimed to assess the ability of CPET to predict postoperative outcome...
February 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26359199/pro-pretransplant-weight-loss-yes
#6
Krista L Lentine
The obesity epidemic has not spared the population with renal failure. Obesity impacts prognosis after kidney transplantation, as markers of obesity are associated with worse outcomes (e.g. delayed graft function, graft failure, cardiovascular disease, costs) compared with ideal values in most studies. Obesity is also potentially modifiable. Kidney transplants are a scarce resource and the obligation to steward organs to good outcomes is inherent in transplant practice. Thus, it is appropriate to establish pretransplant weight loss targets and engage obese patients seeking transplantation in shared responsibility agreements to strive to reach goals...
November 2015: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/26236496/the-impact-and-treatment-of-obesity-in-kidney-transplant-candidates-and-recipients
#7
Gabriel Chan, Pierre Garneau, Roy Hajjar
The prevalence of obesity in patients with chronic kidney failure and renal transplant candidates has paralleled the epidemic in the general population. The associated risks of surgical complications and long-term cardiovascular death are significant: most transplant centers consider obesity a relative contra-indication for transplant. Few studies have focused on conservative weight loss strategies in transplant patients. Studies using administrative databases have found that only a minority of wait-listed patients lose weight and with no apparent benefit to transplant outcomes...
2015: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/25963131/body-mass-index-and-outcome-in-renal-transplant-recipients-a-systematic-review-and-meta-analysis
#8
REVIEW
Jeffrey A Lafranca, Jan N M IJermans, Michiel G H Betjes, Frank J M F Dor
BACKGROUND: Whether overweight or obese end stage renal disease (ESRD) patients are suitable for renal transplantation (RT) is often debated. The objective of this review and meta-analysis was to systematically investigate the outcome of low versus high BMI recipients after RT. METHODS: Comprehensive searches were conducted in MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and CENTRAL (the Cochrane Library 2014, issue 8). We reviewed four major guidelines that are available regarding (potential) RT recipients...
2015: BMC Medicine
https://www.readbyqxmd.com/read/25813752/safety-and-effectiveness-of-bariatric-surgery-in-dialysis-patients-and-kidney-transplantation-candidates
#9
Mohammad H Jamal, Ricard Corcelles, Christopher R Daigle, Tomasz Rogula, Matthew Kroh, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Chronic renal disease is known to adversely affect the results of bariatric surgery. There is a paucity of literature on the safety and effectiveness of bariatric surgery on dialysis patients who are at very advanced stages in their renal disease. The objective of this study was to determine the safety and effectiveness of bariatric surgery in dialysis patients. METHODS: A retrospective review of a prospectively collected database was conducted for dialysis patients who underwent bariatric surgery between January 2006 and January 2012...
March 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/25711520/the-first-polish-liver-transplantation-after-roux-en-y-gastric-bypass-surgery-for-morbid-obesity-a-case-report-and-literature-review
#10
REVIEW
Rafał Marszałek, Paweł Ziemiański, Beata Łągiewska, Marek Pacholczyk, Justyna Domienik-Karłowicz, Janusz Trzebicki, Zbigniew Wierzbicki, Krzysztof Jankowski, Maciej Kosieradzki, Dariusz Wasiak, Maurycy Jonas, Piotr Pruszczyk, Magdalena Durlik, Wojciech Lisik, Andrzej Chmura
BACKGROUND: Morbid obesity is associated with liver pathology, most commonly non-alcoholic steatohepatitis (NASH) leading to cirrhosis. However, the morbid obesity impedes qualification for organ transplantation. CASE REPORT: We present a case report of a 56-year-old woman who underwent bariatric procedure followed by liver transplantation (LTx). Her initial weight was 130.2 kg (BMI 50.9 kg/m2). The patient had a history of arterial hypertension, diabetes, gonarthrosis, and obstructive sleep apnea syndrome and no history of alcohol abuse...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/25483934/improvement-of-graft-function-following-roux-en-y-gastric-bypass-surgery-in-a-morbidly-obese-kidney-recipient-a-case-report-and-literature-review
#11
REVIEW
Paweł Ziemiański, Wojciech Lisik, Rafał J Marszałek, Tomasz Cieciura, Justyna Domienik-Karłowicz, Janusz Trzebicki, Tomasz Gryczewski, Zbigniew Wierzbicki, Maciej Kosieradzki, Magdalena Durlik, Piotr Pruszczyk, Andrzej Chmura
BACKGROUND: Transplantation is the best and approved method of renal replacement therapy. Graft function depends not only on proper regulation of immune processes but also on the optimal control of chronic diseases. The obesity epidemic involves the healthy population and organ recipients equally. Obesity and metabolic syndrome lead to a number of disorders exerting adverse effects on the transplanted organ. CASE REPORT: We report a case of a kidney recipient, 12 years after transplantation, with chronic graft failure (serum creatinine level 2...
2014: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/25139661/laparoscopic-sleeve-gastrectomy-as-a-weight-reduction-strategy-in-obese-patients-after-kidney-transplantation
#12
I Golomb, J Winkler, A Ben-Yakov, C C Benitez, A Keidar
Morbid obesity is associated with increased graft loss and shortened graft survival in kidney transplant patients. Treating obesity in transplant patients may improve graft outcomes. Laparoscopic sleeve gastrectomy (LSG), an effective bariatric operation, is relatively unlikely to interfere with absorption of anti-rejection medications. Data on relevant renal function parameters were collected from all LSGs performed on renal transplant patients at our center (n = 10). The procedure was successful in eight patients, with no mortality, graft rejection or dysfunction...
October 2014: American Journal of Transplantation
https://www.readbyqxmd.com/read/25032099/transplant-options-for-patients-with-type-2-diabetes-and-chronic-kidney-disease
#13
REVIEW
Costas Fourtounas
Chronic kidney disease (CKD) has become a real epidemic around the world, mainly due to ageing and diabetic nephropathy. Although diabetic nephropathy due to type 1 diabetes mellitus (T1DM) has been studied more extensively, the vast majority of the diabetic CKD patients suffer from type 2 diabetes mellitus (T2DM). Renal transplantation has been established as a first line treatment for diabetic nephropathy unless there are major contraindications and provides not only a better quality of life, but also a significant survival advantage over dialysis...
June 24, 2014: World Journal of Transplantation
https://www.readbyqxmd.com/read/24507957/obesity-metabolic-syndrome-and-diabetes-mellitus-after-renal-transplantation-prevention-and-treatment
#14
REVIEW
Karl Martin Wissing, Lissa Pipeleers
The prevalence of the metabolic syndrome in dialysis patients is high and further increases after transplantation due to weight gain and the detrimental metabolic effects of immunosuppressive drugs. Corticosteroids cause insulin resistance, hyperlipidemia, abnormal glucose metabolism and arterial hypertension. The calcineurin inhibitor tacrolimus is diabetogenic by inhibiting insulin secretion, whereas cyclosporine causes hypertension and increases cholesterol levels. Mtor antagonists are responsible for hyperlipidemia and abnormal glucose metabolism by mechanisms that also implicate insulin resistance...
April 2014: Transplantation Reviews
https://www.readbyqxmd.com/read/24272886/laparoscopic-placement-of-adjustable-gastric-band-in-patients-with-autoimmune-disease-or-chronic-steroid-use
#15
Paul Del Prado, Pavlos K Papasavas, Darren S Tishler, Andrea M Stone, Janet S Ng, Sean B Orenstein
BACKGROUND: Past medical or family history of autoimmune diseases and patient chronic steroid use are label contraindications for laparoscopic placement of adjustable gastric band (LAGB). We reviewed our experience with placement of LAGB in patients with autoimmune disease or chronic steroid use. METHODS: This was a retrospective review of our prospective bariatric database. All patients who underwent LAGB and had a diagnosis of autoimmune disease or chronic steroid use with at least 1-year follow-up data were included in the study...
April 2014: Obesity Surgery
https://www.readbyqxmd.com/read/24206856/bariatric-surgery-and-end-stage-organ-failure
#16
REVIEW
Nabil Tariq, Linda W Moore, Vadim Sherman
Morbid obesity increases the risk of complications and allograft failure in transplant patients. Bariatric surgery is both safe and effective in patients with chronic kidney disease and end-stage renal disease, improves eligibility for transplant based on body mass index, and does not affect postoperative immunosuppressant dosing regimens. Bariatric surgery in patients with liver disease has been shown to be safe and effective, although they remain at high risk in the setting of portal hypertension. Sleeve gastrectomy may become increasingly used both pretransplant and posttransplant, as it can result in low complication rates and excellent weight loss, and retains intestinal continuity...
December 2013: Surgical Clinics of North America
https://www.readbyqxmd.com/read/23945119/bariatric-surgery-in-morbidly-obese-patients-with-chronic-renal-failure-prepared-for-kidney-transplantation-case-reports
#17
Monika Proczko, Łukasz Kaska, Jarek Kobiela, Tomasz Stefaniak, Dariusz Zadrożny, Zbigniew Śledziński
Recent years, obesity is a growing health problem also in patients with chronic renal failure and end it's end stage. This situation has a negative impact both on the extension of the waiting period for transplantation, and the survival rate of the transplanted organ and the recipient. Weight loss through lifestyle modification before transplantation is ambiguous. Its well known fact of rapid body mass gain after transplantation, and finally the results of transplantation are not better than those of patients who have not reduced body weight...
July 2013: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/23834048/diabetic-nephropathy-changes-after-diabetes-surgery
#18
REVIEW
S Ros Ruiz
INTRODUCTION: Obesity, as a central piece inside metabolic syndrome, is associated with early chronic kidney disease (CKD). In addition, several observational, cross sectional, and longitudinal studies have demonstrated that obesity is as an independent risk factor for the onset, aggravated course, and poor outcomes of CKD including diabetic nephropathy. This implies that when obesity is reversed, many CKD risk factors and CKD itself could be favorably influenced. So all measures aimed at weight loss are recommended to minimize risks from obesity-related conditions and generate improvements in the metabolic profile...
March 2013: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/23374891/structural-renal-changes-in-obesity-and-diabetes
#19
REVIEW
Kerstin Amann, Kerstin Benz
Overweight, obesity, and associated diseases represent an emerging problem, not only in Western countries but also in the developing world. They are now characterized as epidemic diseases. Obesity is particularly serious because its incidence in children and adolescents increased dramatically: it is estimated that in the United States every eighth adolescent suffers from obesity, which in the long run may reduce life expectancy in the population. Apart from cardiovascular disease (ie, blood pressure, stroke, and coronary heart disease), kidney diseases also have been shown to be associated with obesity...
January 2013: Seminars in Nephrology
https://www.readbyqxmd.com/read/23311979/enteric-oxalate-nephropathy-in-the-renal-allograft-an-underrecognized-complication-of-bariatric-surgery
#20
M L Troxell, D C Houghton, M Hawkey, T D Batiuk, W M Bennett
Enteric hyperoxalosis is a recognized complication of bariatric surgery, with consequent oxalate nephropathy leading to chronic kidney disease and occasionally end-stage renal failure. In patients with prior gastrointestinal bypass surgery, renal allografts are also at risk of oxalate nephropathy. Further, transplant recipients may be exposed to additional causes of hyperoxalosis. We report two cases of renal allograft oxalate nephropathy in patients with remote histories of bariatric surgery. Conservative management led to improvement of graft function in one patient, while the other patient returned to dialysis...
February 2013: American Journal of Transplantation
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