Improved cardiometabolic outcomes after laparoscopic sleeve gastrectomy in a heart transplant patient; a case report

Bariatric surgery is recognized as a viable strategy for treatment of severe obesity in organ transplant recipients. There are limited reports regarding the surgical experience of bariatric surgery in patients who have undergone heart transplantation. A 42-year-old male heart transplant recipient with Class II obesity underwent laparoscopic sleeve gastrectomy (LSG) at Namazi Tertiary Hospital in Shiraz, Iran, to manage post-transplant weight gain and mitigate cardiac transplant rejection risks. Post-operatively, the patient showed notable improvements in cardiac structure and function, including decreased left ventricular dimensions and enhanced tricuspid annular plane systolic excursion. Metabolic parameters stabilized, exemplified by normalized fasting blood sugars and reduced HbA1c levels. Improvements in liver and kidney function also allowed for lowered immunosuppressant dosages. These results demonstrate the potential of LSG to not only enhance cardiac function and metabolic stability but also reduce the need for immunosuppression, underscoring its viability as a strategy to improve transplant outcomes and quality of life. The case highlights the importance of collaborative care and further research to assess long-term benefits in similar patient populations.