Combined Kidney Transplant with Weight Loss Surgeries Proved to be Safe for Obese Patients

Wednesday, November 1, 2023

Many obese patients face various barriers and increased risk for kidney transplant. Thanks to groundbreaking research by surgeons at UI Heath, those barriers may be a thing of the past.

A significant barrier to kidney transplant for many obese patients—increased surgical risks—may soon be a thing of the past, thanks to groundbreaking research by surgeons at UI Heath, the clinical and academic health enterprise of the University of Illinois Chicago. Pioneering robotic-assisted surgery, led by Dr. Enrico Benedetti, professor, and Warren H. Cole, Chair of Surgery, the team has successfully minimized surgical complications in obese patients undergoing kidney transplants. This innovative approach not only offers hope to patients who would otherwise rely on dialysis for kidney disease treatment but also mitigates the severe risks associated with prolonged dialysis.

Dr. Pierpaolo Di Cocco, assistant professor of surgery at UI Health and co-author of the study, highlights the critical role of weight loss surgery in enhancing the success of kidney transplants in obese individuals. "Obesity significantly exacerbates kidney disease, making simultaneous weight loss surgery and kidney transplant a logical progression," Dr. Di Cocco explains. "This combined approach not only promotes weight loss, which improves cardiac function and reduces stress on the new organ, but also addresses end-stage kidney disease and obesity concurrently."

Dr. Tzvetan Tzvetanov, associate professor of surgery, chief of transplantation, and co-author of the paper, emphasizes the transformative potential of this dual surgical intervention in combating the global obesity epidemic. With projections indicating a staggering rise in obesity-related health issues, such as cardiovascular disease and diabetes, addressing obesity becomes paramount in improving kidney health and transplant outcomes.

The study, published in the American Journal of Transplantation, enrolled 20 patients between 2012 and 2019, with an average BMI of 44, indicative of severe obesity. Eleven patients underwent robotic-assisted kidney transplants and sleeve gastrectomy, while nine received kidney transplantation alone.

A comprehensive approach to patient care involving weight-loss education and supervised programs encompassing exercise, diet, and multidisciplinary support ensured optimal outcomes for all participants. While patients undergoing both procedures experienced longer anesthesia durations, the benefits were substantial, with a notable reduction in BMI and excess weight and zero organ rejection incidents.

Dr. Tzvetanov underscores the need for further research to fully comprehend this pioneering approach's long-term benefits. However, the initial results offer promising prospects for obese patients in need of kidney transplants, marking a significant advancement in the field of transplantation surgery.

Co-authors on the paper include Dr. Mario Spaggiari, Dr. Kiara Tulla, Kerim Kaylan, Dr. Mario Masrur, Dr. Chandra Hassan, and Dr. Jorge Almario Alvarez, all esteemed members of the UI Health medical community.

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