Commentary: Peri-Transplant Bariatric Surgery

Morbid obesity often serves as a contraindication to organ transplantation. Furthermore, metabolic complications developed in the peri-operative period and long term after transplant are associated with high mortality. As bariatric surgery is an acceptable measure to treat morbid obesity, it may serve also the transplant population before and after transplant.Methods A review of the literature was done, combined with our own experience with bariatric surgery in kidney and liver transplant recipients before, during, and after transplantation.ResultsPreliminary data show that bariatric surgery seems to be feasible in morbidly obese patients in the setting of transplantation, though associated with high post-operative complication rate. Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYBG) are both effective in the kidney transplant population while LSG is the preferred approach for liver transplant patients.ConclusionsAlthough bariatric surgery in the transplant population is not yet extensively studied and is mostly reported in small series, it seems a useful approach for the treatment of morbid obesity in these high-risk patients. Comparative data regarding optimal timing and type of bariatric procedure and long-term results are warranted.