Bariatric surgery outcomes following organ transplantation: A review study

Table 1 Outcomes of bariatric surgery in patients with a history of organ transplants

Organ	Type of bariatric surgery	Patients (n)	Potential risks	Mean BMI or weight changes after BS	Comorbidities/improvements	Ref.
Liver	RYGB	7	Gastric staple line leakage, EWL	From 44.34 ± 6.08 kg/m2 to 26.47 ± 5.53 kg/m2	DM, HTN, GERD, vascular disease, and OSA	Al-Nowaylati et al[17]
	LSG	12	Infections and leaks	Mean BMI decrease 12.9 kg/m2	Nine out of 12 patients had DM and metabolic syndrome; four out of 12 patients showed a complete improvement after LSG	Tsamalaidze et al[27]
	Open SG	1	-	From 47 kg/m2 to 29.8 kg/m2	DM and arterial HTN	Butte et al[28]
	RYGB, LSG, jejunoileal bypass SG	11	Organ insufficiency	Mean BMI 28.3 ± 5.8 kg/m2	Early surgical site infection, and bleeding	Safwan et al[29]
Kidney	Gastric bypass	5	-	Mean WL of 33 kg	DM, HTN, and hyperlipidemia	Arias et al[11]
	RYGB, LSG	5	-	50% EWL at 2 yr	DM, HTN, hyperlipidemia, polycystic ovarian syndrome, peripheral vascular disease, and CHF	Szomstein et al[7]
	LSG	10	Acute renal failure and sleeve stricture	57% EWL at 6 mo, and 75% EWL at 12 mo	Not mentioned	Golomb et al[30]
		6	-	44.1% EWL at 3 mo, and 75.9% EWL at 12 mo	Morbid obesity	Gazzetta et al[31]
Liver and kidney	LSG	9	Mesh dehiscence after a synchronous incisional hernia repair, bile leakage, and dysphagia that required reoperation	61% EWL	Mesh dehiscence after synchronous incisional hernia repair, bile leak, post-operative dysphagia	Lin et al[18]
Heart	RYGB and LSG	2	-	From 37.5 kg/m2 to 27.5 kg/m2 at 12 mo	HTN, hiperlipidemia, anemia, and hipomagnesemia	Tsamalaidze et al[32]
Heart and kidney	Vertical banded gastroplasty	2	Inadvertent laceration of the pancreas resulting in pseudocyst which may need percutaneous and then surgical drainage	Mean WL of 54 and 56 kg	Not mentioned	Rex et al[33]

BMI: Body mass index; BS: Bariatric surgery; RYGB: Roux-en-Y gastric bypass; EWL: Excess weight loss; LSG: Laparoscopic sleeve gastrectomy; SG: Sleeve gastrectomy; WL: Weight loss; DM: Diabetes mellitus; HTN: Hypertension; GERD: Gastroesophageal reflux disease; OSA: Obstructive sleep apnea; CHF: Congestive heart failure.

Table 2 Dose adjustment of immunosuppressive drugs following bariatric surgery in patients with a history of organ transplants

Organ	Type of bariatric surgery	Patients (n)	Immunosuppressant adjustment compared to patients without organ transplants	Ref.
Liver	LSG	12	No changes	Tsamalaidze et al[27]
		9		Lin et al[18]
	Bariatric surgery	56		Lazzati et al[34]
Kidney	Gastric bypass	2	Increased doses of sirolimus, tacrolimus, and mycophenolate mofetil	Rogers et al[35]
	Laparoscopic gastric bypass	5	No changes	Arias et al[11]
	LSG	10	Two patients with increased doses of tacrolimus and one decreased	Golomb et al[30]
		6	No changes	Gazzetta et al[31]
		5	Decreased dose of cyclosporine	Szomstein et al[7]
	Biliopancreatic diversion	1	No changes	López Deogracias et al[36]
Heart	Laparoscopic gastric banding, laparoscopic robotic-assisted RYGB, and LSG	3	No changes	Tsamalaidze et al[32], Ablassmaier et al[37]
Heart and kidney	Vertical banded gastroplasty	1	Changes based on serum level	Rex et al[33]

LSG: Laparoscopic sleeve gastrectomy; RYGB: Roux-en-Y gastric bypass.