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Chapter-11 Obesity, Metabolic Surgery and Transplantation

BOOK TITLE: Kidney & Pancreas Transplantation

Author
1. Friesen Timothee
2. Gentles Charmaine
3. Gellman Larry
4. Gadaleta Dominick
ISBN
9789351523390
DOI
10.5005/jp/books/12547_12
Edition
1/e
Publishing Year
2015
Pages
4
Author Affiliations
1. Finney Trimble Surgical Associates, Greater Baltimore Medical Center, Baltimore, Maryland, USA
2. North Shore-LIJ Health System, Hempstead, New York, USA
3. North Shore-LIJ Health System, Hempstead, New York, USA
4. North Shore-LIJ Health System and Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
Chapter keywords
obesity, metabolic surgery, hypertension, renal transplant, BMI, nutritional evaluation, psychiatric evaluation, diabetes

Abstract

This chapter discusses about obesity, metabolic surgery and transplantation, where obesity leads to a reduced life expectancy and often to an increase in multiple health problems, and bariatric surgery has been shown to help obese patients with solid organ failure become transplant candidates. Morbid obesity is a well-known risk factor for multiple medical problems such as diabetes and hypertension, which in turn can cause proteinuria, nephrotic syndrome and chronic kidney disease. Obesity impacts short- and long-term renal transplant recipient outcomes negatively. Although it acknowledges that there is limited data for exclusion from kidney transplantation based on obesity the existing practice guidelines issued by the American Society of Transplantation recommend a BMI of less than 30 prior to transplantation. Surgery must be performed in the setting of a multidisciplinary clinic with psychiatric and nutritional evaluation and education, and all patients must have long-term follow-up.

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