1 Division of Transplantation, University of Illinois Hospital & Health Sciences System, Chicago, IL.
Transplantation. 2015 Jul;99(7):1495-8. doi: 10.1097/TP.0000000000000541.
Kidney transplantation confers a well-documented survival advantage for patients with end-stage renal disease (ESRD) over dialysis, regardless of body mass index (BMI). However, obese patients with ESRD have limited access to kidney transplantation. In most transplant centers, a patient with a BMI above 35 to 40 kg/m is either completely excluded from transplantation or is required to lose weight before being considered for transplantation.
Herein, we present the first case of a 35-year-old woman with a BMI of 42 kg/m (96.8 kg) and ESRD, who underwent combined robot-assisted kidney transplant and sleeve gastrectomy.
The total operative time was 318 minutes with an estimated blood loss of 125 mL. At 24 months after transplantation, the patient's weight, BMI, creatinine, and estimated glomerular filtration rate were 81.9 kg, 35.1 kg/m, 0.79 mg/dL, and 81.2 mL/min per 1.73 m, respectively.
Combined robot-assisted kidney transplant and sleeve gastrectomy is feasible in morbidly obese patients and adds little additional operative time.
肾移植为终末期肾病（ESRD）患者带来了经过充分记录的生存优势，无论其体重指数（BMI）如何。然而，肥胖的 ESRD 患者获得肾移植的机会有限。在大多数移植中心，BMI 超过 35 至 40kg/m 的患者要么完全被排除在移植之外，要么在考虑移植之前必须减肥。
在此，我们报告了首例 BMI 为 42kg/m（96.8kg）的 35 岁女性 ESRD 患者，接受了机器人辅助肾移植联合袖状胃切除术。
总手术时间为 318 分钟，估计失血量为 125 毫升。移植后 24 个月，患者的体重、BMI、肌酐和估算肾小球滤过率分别为 81.9kg、35.1kg/m、0.79mg/dL 和 81.2mL/min/1.73m。
机器人辅助肾移植联合袖状胃切除术在病态肥胖患者中是可行的，并且增加的手术时间很少。
