Bariatric surgery and end-stage organ failure

Morbid obesity increases the risk of complications and allograft failure in transplant patients. Bariatric surgery is both safe and effective in patients with chronic kidney disease and end-stage renal disease, improves eligibility for transplant based on body mass index, and does not affect postoperative immunosuppressant dosing regimens. Bariatric surgery in patients with liver disease has been shown to be safe and effective, although they remain at high risk in the setting of portal hypertension. Sleeve gastrectomy may become increasingly used both pretransplant and posttransplant, as it can result in low complication rates and excellent weight loss, and retains intestinal continuity.