Dziodzio Tomasz, Biebl Matthias, Öllinger Robert, Pratschke Johann, Denecke Christian
Department of Surgery, Campus Virchow and Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13352, Berlin, Germany.
Obes Surg. 2017 Oct;27(10):2696-2706. doi: 10.1007/s11695-017-2854-8.
Obesity is linked to inferior transplant outcome. Bariatric surgery (BS) is an established treatment of morbid obesity. We provide an overview on BS in the field of kidney (KT) and liver transplantation (LT). In end-stage renal disease (ESRD) and KT patients, BS seems safe and feasible. Complication rates were slightly higher compared to the non-transplant population, whereas weight loss and improvement of comorbidities were comparable. Sleeve gastrectomy (SG) was the preferred procedure before KT and superior to gastric bypass (GB) in regard to mortality and morbidity. If conducted after KT, both procedures showed comparable results. BS before LT was associated with high complication rates, in particular after GB. Albeit distinct complications, SG conducted after LT showed the best results. Immunosuppression (IS) changes after BS were rare.
肥胖与移植效果较差有关。减重手术（BS）是治疗病态肥胖的既定方法。我们概述了肾脏移植（KT）和肝脏移植（LT）领域中的减重手术。在终末期肾病（ESRD）和肾脏移植患者中，减重手术似乎是安全可行的。与非移植人群相比，并发症发生率略高，而体重减轻和合并症改善情况相当。袖状胃切除术（SG）是肾脏移植前的首选手术，在死亡率和发病率方面优于胃旁路术（GB）。如果在肾脏移植后进行，两种手术的结果相当。肝脏移植前的减重手术与高并发症发生率相关，尤其是胃旁路术后。尽管并发症不同，但肝脏移植后进行袖状胃切除术效果最佳。减重手术后免疫抑制（IS）的变化很少见。
