Clinical case study shows bariatric surgery may improve transplant success in patients with morbid obesity and end-stage CKD, indicating its potential benefits.
Background. Obese patients with end-stage chronic kidney disease (CKD) face obstacles to transplantation due to their weight. However, the most effective method of weight loss in the form of bariatric surgery, according to current clinical guidelines, is contraindicated in severe irreversible changes in the kidneys. Description of a clinical case. The article presents descriptions of clinical examples of bariatric surgeries performed on patients with morbid obesity and end-stage chronic kidney disease, followed by heterotopic cadaveric kidney transplantation. The results were assessed 12 months after kidney transplantation. Conclusion. Currently in Russia, despite the existing discrepancies in national clinical guidelines for kidney transplantation and clinical guidelines for the treatment of obesity, in terms of bariatric surgery, for patients with end-stage CKD and morbid obesity, longitudinal gastrectomy may be the only opportunity to obtain a donor kidney with a minimal risk of transplant rejection.
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Смирнов et al. (2025) studied this question.
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