Cabrera-Arroyo JF, Alonso-de la Rosa JE, Rodríguez-Muñoz A, Verboonen-Sotelo JS, Ponce de León-Palomares J, Romero-Manzano J, Bonilla-Gutiérrez DM, Alejandro-Córdova P

Language: Spanish
References: 9
Page: 35-38
PDF size: 230.22 Kb.

ABSTRACT

Introduction: in recent years, a global trend has been observed toward modifying the timing of bariatric surgery in relation to kidney transplantation, performing it either simultaneously with or after the transplant. Nevertheless, we consider that the optimal timing for bariatric surgery is prior to kidney transplantation, using it as a bridging strategy to transplantation. Objective: to demonstrate the safety of the ideal timing for offering bariatric surgery to obese recipients and donors in a kidney transplant protocol. Material and methods: a review was conducted using the electronic literature available in PubMed/MEDLINE, with results from 2019 to 2025. The keywords were descriptors of bariatric surgery and kidney transplantation, referenced in every word of the study text. We found 187 articles, from which we selected those that discussed the appropriate timing for performing kidney transplantation in relation to bariatric surgery. Results: among the variety of articles reviewed, the vast majority establish bariatric surgery before kidney transplantation, even as a bridge to kidney transplantation, achieving eligibility, using a proposed algorithm. Considering the same surgical time, they comment that it only increases the surgical time, with improved weight loss. Regarding performing the transplant first and then bariatric surgery, they mention that there is no difference in weight loss; however, there are more complications, even an increased risk of rejection within one year. Conclusions: almost all the articles reviewed are retrospective in design, so randomized, controlled studies are still needed to ensure adequate methodological development. Based on this review, we agree with the algorithm that a bariatric procedure should be performed first, as a bridge to kidney transplantation, within a considerable timeframe determined by the transplant committee. We do not consider both procedures advisable at the same surgical time.

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