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Bariatric transplant

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https://www.readbyqxmd.com/read/28439568/bariatric-surgery-and-kidney-related-outcomes
#1
Alex R Chang, Morgan E Grams, Sankar D Navaneethan
The prevalence of severe obesity in both the general and the chronic kidney disease (CKD) populations continues to rise, with more than one-fifth of CKD patients in the United States having a body mass index of ≥35 kg/m(2). Severe obesity has significant renal consequences, including increased risk of end-stage renal disease (ESRD) and nephrolithiasis. Bariatric surgery represents an effective method for achieving sustained weight loss, and evidence from randomized controlled trials suggests that bariatric surgery is also effective in improving blood pressure, reducing hyperglycemia, and even inducing diabetes remission...
March 2017: KI Reports
https://www.readbyqxmd.com/read/28434033/the-gut-microbiome-as-a-target-for-prevention-and-treatment-of-hyperglycaemia-in-type-2-diabetes-from-current-human-evidence-to-future-possibilities
#2
REVIEW
Louise Brunkwall, Marju Orho-Melander
The totality of microbial genomes in the gut exceeds the size of the human genome, having around 500-fold more genes that importantly complement our coding potential. Microbial genes are essential for key metabolic processes, such as the breakdown of indigestible dietary fibres to short-chain fatty acids, biosynthesis of amino acids and vitamins, and production of neurotransmitters and hormones. During the last decade, evidence has accumulated to support a role for gut microbiota (analysed from faecal samples) in glycaemic control and type 2 diabetes...
April 22, 2017: Diabetologia
https://www.readbyqxmd.com/read/28405876/laparoscopic-sleeve-gastrectomy-in-kidney-transplant-candidates-a-case-series
#3
Sergio Carandina, Laurent Genser, Manuela Bossi, Laura Montana, Alexandre Cortes, Marie Seman, Marc Danan, Christophe Barrat
BACKGROUND: Patients with a body mass index (BMI) >35 kg/m(2) who 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. METHODS: This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France)...
April 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28364810/liver-transplantation-and-bariatric-surgery-best-approach
#4
REVIEW
Duminda Suraweera, Erik Dutson, Sammy Saab
Obesity has become increasingly prevalent, and the number of obese patients in need of liver transplant is expected to continue to increase. In addition, liver disease due to nonalcoholic fatty liver disease is expected to become the leading cause of liver transplantation in the near future. However, obesity remains a relative contraindication in liver transplant. New strategies in managing this patient population are clearly needed. To this end, the authors review the current literature on the efficacy of bariatric surgery in the setting of liver transplantation in obese patients...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28355381/bariatric-surgery-in-individuals-with-liver-cirrhosis-a-narrative-review
#5
Everton Cazzo, Martinho Antonio Gestic, Murillo Pimentel Utrini, Felipe David Mendonça Chaim, Francisco Callejas-Neto, José Carlos Pareja, Elinton Adami Chaim
Introduction: Bariatric surgery has become the gold standard treatment for morbid obesity, but there is no consensus regarding its safety and efficacy among individuals with chronic liver diseases. Objective: To critically evaluate the existing evidence on literature about bariatric surgery in individuals with liver cirrhosis. Method: Narrative review performed by means of an online search in the MEDLINE and LILACS databases. Results: Bariatric surgery is safe and effective in individuals with chronic liver disease without clinical decompensation or significant portal hypertension...
February 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28281236/simultaneous-liver-transplantation-and-sleeve-gastrectomy-prohibitive-combination-or-a-necessity
#6
Eviatar Nesher, Eytan Mor, Amir Shlomai, Michal Naftaly-Cohen, Renana Yemini, Alexander Yussim, Marius Brown, Andrei Keidar
Previously, many morbidly obese (MO) patients were denied liver transplantation (LT) because of the higher operative risk. However, nowadays, 5 and 10 years graft survival is the rule, and patients whose lives can be prolonged with LT are dying of obesity-related comorbidities. Recent experience suggests that weight reduction in MO liver transplant recipients would improve their long-term survival. The bariatric surgery before LT is contraindicated for patients with decompensated cirrhosis, while post-transplant intervention is associated with increased technical difficulty...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28281234/portomesenteric-vein-thrombosis-post-laparoscopic-sleeve-gastrectomy-case-series-and-literature-review
#7
S Alman AlSabah, Mohammed AlRuwaished, Sulaiman Almazeedi, Eliana Al Haddad, Elie Chouillard
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is today one of the leading procedures in bariatric surgery, and portomesenteric vein thrombosis (PMVT) has been reported as one of its rare complications. The purpose of this study is to determine the prevalence, clinical presentation, and outcomes of PMVT in patients undergoing LSG. METHODS: A retrospective study of a database of all post-LSG patients was conducted on the patients who developed PMVT post-LSG from July 2011 to March 2016, at Amiri Hospital, Kuwait...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28276821/current-and-future-treatment-options-in-non-alcoholic-steatohepatitis-nash
#8
Nikos Lazaridis, Emmanuel Tsochatzis
Non-alcoholic steatohepatitis (NASH) is a chronic liver disease that can progress to cirrhosis and hepatocellular carcinoma. Diagnosis of NASH requires a liver biopsy and is defined as presence of hepatic steatosis, ballooning and lobular inflammation with or without fibrosis. Although NASH is the most common cause of liver disease in the west world and among the top three indications for liver transplantation, there are no universally accepted pharmacological therapies and therapeutic advances have been slow...
April 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28260459/bariatric-surgery-in-renal-transplant-patients
#9
Osama Gheith, Torki Al-Otaibi, Medhat A Halim, Tarek Mahmoud, Ahmed Mosaad, Jude Yagan, Zakaria Zakaria, Suzann Rida, Prasad Nair, Rashad Hassan
OBJECTIVES: The idea of transplanting organs is not new, nor is the disease of obesity. Obese transplant recipients have greater risk of early death than their cohorts, which is not due to increased rejection but due to obesity-related complications, including arterial hypertension, diabetes, and delayed graft function. Here, our aim was to evaluate the effects of bariatric surgery versus lifestyle changes on outcomes of moderate to severely obese renal transplant recipients. MATERIALS AND METHODS: Twenty-two morbidly obese patients with stable graft function who underwent bariatric surgery were compared with 44 obese patients on lifestyle management (control group)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28217701/gut-microbiota-and-oxalate-homeostasis
#10
Marguerite Hatch
This perspective focuses on how the gut microbiota can impact urinary oxalate excretion in the context of hyperoxaluria, a major risk factor in kidney stone disease. In the genetic disease of Primary Hyperoxaluria Type 1 (PH1), an increased endogenous production of oxalate, due to a deficiency of the liver enzyme alanine-glyoxylate aminotransferase (AGT), results in hyperoxaluria and oxalate kidney stones. The constant elevation in urinary oxalate in PH1 patients ultimately leads to tissue deposition of oxalate, renal failure and death and the only known cure for PH1 is a liver or liver-kidney transplant...
January 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28204931/postero-inferior-pedicle-surgical-technique-for-the-treatment-of-grade-iii-gynecomastia
#11
Sophie Thiénot, Nicolas Bertheuil, Raphaël Carloni, Cécile Méal, Sylvie Aillet, Christian Herlin, Eric Watier
INTRODUCTION: Surgical treatment of Grade III gynecomastia generally utilizes mastectomy techniques and free transplantation of the nipple-areola complex. Moreover, with rising obesity rates and the development of bariatric surgery, an increasing demand for correctional surgery for pseudogynecomastia has been observed, which is comparable to Grade III gynecomastia in terms of its surgical management. Here, we describe an innovative technique to deal with these new demands: fascio-cutaneous flap by postero-inferior pedicle...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28139330/management-of-the-obese-kidney-transplant-candidate
#12
REVIEW
Julie Lesage, John S Gill
Obesity is an increasingly common condition that can exclude end stage renal disease patients from consideration of kidney transplantation. The optimal management of obese transplant candidates is uncertain, especially the use of pharmacologic therapies or bariatric surgery. We review the rationale to consider transplantation in obese patients, the impact of obesity on access to kidney transplantation, the evidence for obese patients to lose weight loss prior to kidney transplantation, peri-operative management considerations and specific weight loss strategies prior to transplantation...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28122320/revisional-bariatric-surgery-in-a-transplant-patient
#13
Salman Al Sabah, Eliana Al Haddad
INTRODUCTION: A BMI of over 35-45kg/m2 is deemed the upper limit for considering a patient for a renal transplant. Voluntary weight loss attempts are a major concern for patients while on hemodialysis, however, bariatric surgeries have opened up a new door to notable weight loss results, even demonstrating significant improvements of patients' diabetic profile and hypertension. CASE REPORT: Case of a 52-year-old male with a BMI of 42 in end-stage renal disease, that needed a kidney transplant but was ineligible to be placed on the waiting list due to his weight...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28092289/the-impact-of-obesity-on-heart-failure
#14
Alexander B Zhai, Haissam Haddad
PURPOSE OF REVIEW: Obesity, a growing global health problem, contributes to the development of heart failure. However, increased BMI seems protective for those with established disease, a phenomenon known as the 'obesity paradox'. In this review, we outline the mechanism through which obesity can contribute to the development of heart failure, explore the concept of obesity paradox, and highlight the challenges that obesity presents for advanced heart failure therapy. RECENT FINDINGS: Although the mechanism underlying the obesity paradox is complex, meta-analysis shows that intentional weight loss through bariatric surgery can indeed improve cardiac structure and function...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27960020/-the-hyperoxalurias
#15
Martino Marangella, Michele Petrarulo, Francesca Bermond, Cristina Marcuccio, Corrado Vitale
Oxalate (Ox) is an end-product of metabolism, important for poor solubility of its calcium salt in biological fluids. Ox can therefore be found in about 70% of urinary calculi. Hyperoxaluria (HOx) defined as Ox exceeding 0.5 mmol)/day, may cause nephrolithiasis/nephrocalcinosis and may be classified as dietary (DH), enteric (EH) or primary (PH). Fractional intestinal absorption of Ox is less than 10%, but increases to over 20% at calcium intakes below 200 mg/day. DH is often related to low-calcium diets. EH is caused by non-absorbed fatty acids which bind to calcium and lower its concentration in the intestinal lumen...
2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27939909/liver-failure-after-long-limb-gastric-bypass
#16
Mike Ralki, David Cassiman, Jurgen Van Dongen, Michel Ferrante, Lode Van Overbeke
Liver failure is reported with increasing frequency in patients who underwent bariatric surgery for morbid obesity. In most cases, liver transplantation is the only possible treatment to avoid fatal outcome. Although most cases are observed after older bariatric surgery techniques characterized by high malabsorption rates, we report on a 38-year-old woman who developed liver failure seven months after long-limb gastric bypass.
December 8, 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#17
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27880977/bariatric-surgery-for-nonalcoholic-steatohepatitis-a-clinical-and-cost-effectiveness-analysis
#18
Matthew J Klebanoff, Kathleen E Corey, Jagpreet Chhatwal, Lee M Kaplan, Raymond T Chung, Chin Hur
Nonalcoholic steatohepatitis (NASH) affects 2%-3% of the US population and is expected to become the leading indication for liver transplantation in the next decade. Bariatric surgery may be an effective but expensive treatment for NASH. Using a state-transition model, our analysis assessed the effectiveness and cost-effectiveness of surgery to manage NASH. We simulated the benefits and harms of laparoscopic Roux-en-Y gastric bypass surgery in patients defined by weight class (overweight, mild obesity, moderate obesity, and severe obesity) and fibrosis stage (F0-F3)...
April 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27677115/combined-liver-transplantation-and-sleeve-gastrectomy-for-end-stage-liver-disease-in-a-bariatric-patient-first-european-case-report
#19
Laura Tariciotti, Stefano D'Ugo, Tommaso Maria Manzia, Valeria Tognoni, Giuseppe Sica, Paolo Gentileschi, Giuseppe Tisone
INTRODUCTION: Obesity is a contributor to the global burden of chronic diseases, including non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH). NASH cirrhosis is becoming a leading indication for liver transplant (LT). Obese transplanted patients have higher morbidity and mortality rates. One strategy, to improve the outcomes in these patients, includes bariatric surgery at the time of LT. Herein we report the first European combined LT and sleeve gastrectomy (SG)...
September 21, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27534874/from-chronic-kidney-disease-to-kidney-transplantation-the-impact-of-obesity-and-its-treatment-modalities
#20
REVIEW
Brian Camilleri, Julie M Bridson, Ajay Sharma, Ahmed Halawa
Obesity is associated with worse short-term outcomes after kidney transplantation but the effect on long-term outcomes is unknown. Although some studies have reported worse outcomes for obese recipients when compared to recipients with a BMI in the normal range, obese recipients who receive a transplant have better outcomes than those who remain wait-listed. Whether transplant candidates should be advised to lose weight before or after transplant has been debated and this is mainly due to the gap in the literature linking pre-transplant weight loss with better outcomes post-transplantation...
October 2016: Transplantation Reviews
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