Bariatric Surgery Improves Outcomes in Live Kidney Donors With Obesity

Live kidney donors with obesity who receive bariatric surgery prior to donation have improved outcomes compared with those who do not receive surgery prior to donation, according to a recent literature review.

Findings were presented on August 28, 2017, by Dr Jorge Ortiz at the 2nd Annual Kidney Congress in Philadelphia, Pennsylvania.
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It is well known that obesity can be a barrier to live kidney donor selection. Although undergoing bariatric surgery to reduce obesity prior to donating a kidney has shown promise, the associated risks remain unclear.

For their review, Ortiz and colleagues evaluated existing literature to determine the risks and benefits of bariatric surgery in this setting. Additionally, analyses of costs and benefits were conducted to provide objective data for each possible scenario.

Results indicated that live kidney donation is associated with better outcomes than deceased kidney donation. However, the risk of complications faced by live donors is worsened by obesity. The researchers found that a higher body mass index among donors is associated with worse outcomes among recipients. They also found that bariatric surgery decreases mortality and leads to sustained weight loss.

The cost-benefit analysis showed a benefit-to-cost ratio of 3.64 for bariatric surgery prior to live donation by donors with obesity, compared with 3.19 for live donation by donors with obesity and 0.97 for a deceased donor.

“Our results suggest that [bariatric surgery] for an [obese live kidney donor] has the potential to increase the number of live donors and improve outcomes,” the researchers concluded. “However, more data is required; thus we recommend a registry of patients who have undergone both procedures.”

—Christina Vogt

Reference:

Ortiz J. Bariatric surgery for obese live kidney donors: an analysis of risks and benefits. Paper presented at: 2nd Annual Kidney Congress; August 28-30, 2017. Philadelphia, PA. http://kidney.conferenceseries.com/abstract/2017/bariatric-surgery-for-obese-live-kidney-donors-an-analysis-of-risks-and-benefits.