Bariatric surgery to achieve transplant in end-stage organ disease patients: A systematic review and meta-analysis.
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
31
03
2020
revised:
29
04
2020
accepted:
30
04
2020
pubmed:
1
7
2020
medline:
24
11
2020
entrez:
1
7
2020
Statut:
ppublish
Résumé
As obesity prevalence grows, more end-stage organ disease patients will be precluded from transplant. Numerous reports suggest bariatric surgery in end-stage organ disease may help patients achieve weight loss sufficient for transplant listing. We performed a systematic review/meta-analysis of studies of bariatric surgery to achieve solid organ transplant listing. Among 82 heart failure patients, 40.2% lost sufficient weight for listing, 29.3% were transplanted, and 8.5% had sufficient improvement with weight loss they no longer required transplantation. Among 28 end-stage lung disease patients, 28.6% lost sufficient weight for listing, 7.1% were transplanted, and 14.3% had sufficient improvement following weight loss they no longer required transplant. Among 41 cirrhosis patients, 58.5% lost sufficient weight for listing, 41.5% were transplanted, and 21.9% had sufficient improvement following weight loss they no longer required transplant. Among 288 end-stage/chronic kidney disease patients, 50.3% lost sufficient weight for listing and 29.5% were transplanted. Small sample size and publication bias are limitations; however, bariatric surgery may benefit select end-stage organ disease patients with obesity that precludes transplant candidacy.
Sections du résumé
BACKGROUND
As obesity prevalence grows, more end-stage organ disease patients will be precluded from transplant. Numerous reports suggest bariatric surgery in end-stage organ disease may help patients achieve weight loss sufficient for transplant listing.
METHODS
We performed a systematic review/meta-analysis of studies of bariatric surgery to achieve solid organ transplant listing.
RESULTS
Among 82 heart failure patients, 40.2% lost sufficient weight for listing, 29.3% were transplanted, and 8.5% had sufficient improvement with weight loss they no longer required transplantation. Among 28 end-stage lung disease patients, 28.6% lost sufficient weight for listing, 7.1% were transplanted, and 14.3% had sufficient improvement following weight loss they no longer required transplant. Among 41 cirrhosis patients, 58.5% lost sufficient weight for listing, 41.5% were transplanted, and 21.9% had sufficient improvement following weight loss they no longer required transplant. Among 288 end-stage/chronic kidney disease patients, 50.3% lost sufficient weight for listing and 29.5% were transplanted.
CONCLUSIONS
Small sample size and publication bias are limitations; however, bariatric surgery may benefit select end-stage organ disease patients with obesity that precludes transplant candidacy.
Identifiants
pubmed: 32600846
pii: S0002-9610(20)30253-1
doi: 10.1016/j.amjsurg.2020.04.041
pmc: PMC7484004
mid: NIHMS1607267
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
566-579Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR003097
Pays : United States
Organisme : NIDDK NIH HHS
ID : T35 DK116670
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors all confirm that they have no potential financial, professional, or personal conflicts of interest to disclose. BJO, JWP, RMC, ABS, CEL, NAT, JEL.
Références
Am J Transplant. 2019 Feb;19 Suppl 2:184-283
pubmed: 30811890
Int J Surg Case Rep. 2017;31:86-88
pubmed: 28122320
Surg Endosc. 2018 Apr;32(4):2159-2164
pubmed: 29075966
Transplant Proc. 2006 Nov;38(9):3109-11
pubmed: 17112911
Prog Transplant. 2013 Mar;23(1):28-32
pubmed: 23448817
Am J Transplant. 2018 Jan;18 Suppl 1:114-171
pubmed: 29292605
Hepatology. 2014 Mar;59(3):1144-65
pubmed: 24716201
Obes Surg. 2012 Jan;22(1):119-23
pubmed: 21611875
Transplant Proc. 2014 Jul-Aug;46(6):1741-4
pubmed: 25131025
Obes Surg. 2019 Apr;29(4):1122-1129
pubmed: 30723879
Surg Obes Relat Dis. 2015 Jan-Feb;11(1):88-93
pubmed: 25127439
Obes Surg. 2019 Sep;29(9):3021-3029
pubmed: 31230201
Nephrol Dial Transplant. 2015 Nov;30(11):1790-7
pubmed: 25007790
Surg Obes Relat Dis. 2008 Mar-Apr;4(2):159-64; discussion 164-5
pubmed: 18294923
Obes Surg. 2012 Apr;22(4):555-9
pubmed: 22207407
J Heart Lung Transplant. 2016 Jan;35(1):1-23
pubmed: 26776864
Surg Endosc. 2019 Jun;33(6):1952-1958
pubmed: 30367295
Clin Cardiol. 2008 Nov;31(11):516-20
pubmed: 19006115
N Engl J Med. 2019 Dec 19;381(25):2440-2450
pubmed: 31851800
Am J Kidney Dis. 2008 Oct;52(4):e15-7
pubmed: 18617303
Transplant Proc. 2013 Mar;45(2):798-9
pubmed: 23498822
Case Rep Transplant. 2013;2013:279651
pubmed: 24386588
Case Rep Transplant. 2018 Jul 24;2018:2182083
pubmed: 30140481
Int J Surg Case Rep. 2019;57:19-21
pubmed: 30875624
Obes Surg. 2017 Oct;27(10):2649-2655
pubmed: 28451929
Surg Obes Relat Dis. 2018 Sep;14(9):1269-1273
pubmed: 29929856
Am J Transplant. 2012 Jul;12(7):1663-4
pubmed: 22741750
Ann Intern Med. 2009 Aug 18;151(4):W65-94
pubmed: 19622512
Surg Obes Relat Dis. 2015 Mar-Apr;11(2):419-23
pubmed: 25813752
Obes Surg. 2019 Aug;29(8):2373-2380
pubmed: 31134476
Surg Obes Relat Dis. 2014 May-Jun;10(3):479-84
pubmed: 24462310
JAMA. 2016 Jun 7;315(21):2284-91
pubmed: 27272580
Transplant Proc. 2019 Jan - Feb;51(1):33-37
pubmed: 30598229
J Obes. 2018 Jan 14;2018:7498258
pubmed: 29593899
Heart Lung Circ. 2012 Dec;21(12):847-9
pubmed: 22743291
JAMA. 2018 Jan 16;319(3):279-290
pubmed: 29340677
Nutr Clin Pract. 2015 Jun;30(3):383-92
pubmed: 25547336
Obes Surg. 2005 Apr;15(4):567-70
pubmed: 15946440
Surg Obes Relat Dis. 2013 Sep-Oct;9(5):653-8
pubmed: 23701857
Surg Obes Relat Dis. 2007 Sep-Oct;3(5):503-7
pubmed: 17903770
J Heart Lung Transplant. 2013 Mar;32(3):377-8
pubmed: 23290460
Surg Obes Relat Dis. 2015 May-Jun;11(3):489-506
pubmed: 26093765
Obes Surg. 2017 Nov;27(11):2951-2955
pubmed: 28500419
Surgery. 2017 Aug;162(2):358-365
pubmed: 28411866
J Heart Lung Transplant. 2015 Jan;34(1):1-15
pubmed: 25085497
Liver Transpl. 2019 Apr;25(4):538-544
pubmed: 30588743
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Am J Transplant. 2015 Apr;15(4):1126-7
pubmed: 25801867
J Card Fail. 2008 Apr;14(3):198-202
pubmed: 18381182
Nutr Clin Pract. 2007 Feb;22(1):16-21
pubmed: 17242450
J Heart Lung Transplant. 2015 Nov;34(11):1489-91
pubmed: 26215331
Obes Surg. 2016 Mar;26(3):486-93
pubmed: 26163362
Artif Organs. 2012 Apr;36(4):450-1
pubmed: 22489728
Obes Surg. 2002 Jun;12(3):416-8
pubmed: 12082900
Wideochir Inne Tech Maloinwazyjne. 2013 Jun;8(2):174-7
pubmed: 23837104
JAMA Surg. 2014 Mar;149(3):275-87
pubmed: 24352617
Transplantation. 2009 Apr 27;87(8):1167-73
pubmed: 19384163
Ann Transplant. 2012 Jan-Mar;17(1):108-12
pubmed: 22466915
Surg Obes Relat Dis. 2007 Nov-Dec;3(6):648-51
pubmed: 17936084
JSLS. 2017 Jul-Sep;21(3):
pubmed: 28951657
Can J Kidney Health Dis. 2016 Nov 29;3:2054358116675344
pubmed: 28270925
Hepatology. 2019 Aug;70(2):487-495
pubmed: 28833326
Obes Surg. 2017 Oct;27(10):2613-2618
pubmed: 28405876
J Card Surg. 2016 Feb;31(2):120-2
pubmed: 26749254
Surg Obes Relat Dis. 2015 Nov-Dec;11(6):1406-7
pubmed: 26499353
Clin Transplant. 2018 May;32(5):e13232
pubmed: 29488657
Surg Obes Relat Dis. 2017 Jun;13(6):909-915
pubmed: 28216112
Clin Gastroenterol Hepatol. 2017 Apr;15(4):504-510
pubmed: 28017845
Transplantation. 2018 Jun;102(6):961-968
pubmed: 29215463
BMC Med Res Methodol. 2017 Jul 17;17(1):107
pubmed: 28716005
J Clin Med Res. 2012 Apr;4(2):127-9
pubmed: 22505986
Am J Transplant. 2018 Feb;18(2):410-416
pubmed: 28805345