Newswise — A kidney transplant is commonly denied to sufferers who’re overweight as a consequence of an elevated danger of surgical problems, notably infections. Surgeons at UI Heath — the scientific and tutorial well being enterprise of the College of Illinois Chicago — have pioneered the usage of robotic-assisted surgical procedure for kidney transplants in overweight sufferers to efficiently scale back surgical problems. The process has opened up a life-saving door to sufferers who would in any other case be caught on dialysis to deal with their kidney illness, which carries its personal severe dangers.
The UIC group, led by Dr. Enrico Benedetti, professor and Warren H. Cole Chair of Surgical procedure, has proven that robotic-assisted kidney transplant and weight reduction surgical procedure could be carried out safely. Their outcomes are published within the American Journal of Transplantation.
“Weight problems is a significant danger issue for kidney illness,” stated Dr. Pierpaolo Di Cocco, assistant professor of surgical procedure at UIC and co-author of the paper. “Performing robotic-assisted weight reduction surgical procedure along with kidney transplant is the logical subsequent step as a result of with one surgical procedure, we give the transplant a greater shot at success as a result of the burden loss the affected person will expertise helps enhance cardiac operate and scale back stress on the brand new organ.”
“With this simultaneous surgical strategy, we will deal with end-stage kidney illness weight problems — a significant participant in kidney illness — on the similar time with a single operation and a single course of anesthesia,” stated Dr. Tzvetanov, affiliate professor of surgical procedure, chief of transplantation and a co-author on the paper.
Weight problems is taken into account a worldwide epidemic, in line with the World Well being Group. By 2030, the variety of obese and overweight people worldwide is projected to succeed in 2.16 billion and 1.12 billion, respectively.
Weight problems is a significant danger issue for heart problems and diabetes, which in flip impacts the development of power kidney illness. Usually sufferers are handled with dialysis for years earlier than they obtain a kidney transplant, which stays the most effective remedy for end-stage kidney illness. However for sufferers with weight problems, a kidney transplant is probably not permitted.
Sleeve gastrectomy is a process that reduces the dimensions of the abdomen by roughly 75% and is likely one of the commonest weight-loss surgical procedures.
Di Cocco and colleagues enrolled 20 sufferers into the research between 2012 and 2019. On common, sufferers had physique mass indices, or BMI, of 44. A BMI of 30 or above is indicative of weight problems.
Eleven sufferers acquired a robotic-assisted kidney transplant and sleeve gastrectomy and 9 sufferers acquired robotic-assisted kidney transplantation alone.
All sufferers acquired weight-loss training and took part in a medically supervised weight reduction program, which consisted of train and weight-reduction plan suggestions in addition to visits with a multidisciplinary group of bariatric surgeons, nurse practitioners, medical consultants, dietitians, psychologists and train physiologists.
Sufferers who underwent each procedures had been underneath anesthesia roughly 1 hour longer than those that underwent kidney transplantation alone. Two sufferers within the kidney transplant group skilled organ rejection at one yr and three years post-surgery. No sufferers within the kidney-transplant-plus-sleeve-gastrectomy group skilled organ rejection.
A yr after the surgical procedure, BMI dropped a median of 9 factors within the group who acquired the mixed robotic sleeve gastrectomy and robotic-assisted kidney transplants. The transplant-only group gained a median of two factors. Sufferers within the dual-procedure group skilled a 50% drop in extra weight, roughly.
“Whereas it’s encouraging that sufferers can safely endure each robotic-assisted kidney transplant and weight reduction surgical procedure safely, it is going to take extra follow-up time for us to grasp all of the potential advantages of this process,” Tsvetanov stated.
Dr. Mario Spaggiari, Dr. Kiara Tulla, Kerim Kaylan, Dr. Mario Masrur, Dr. Chandra Hassan and Dr. Jorge Almario Alvarez, the entire UIC, are co-authors on the paper.