Transplant Trial Watch

Comparison of Kidney Transplantation Outcomes Between Patients with and Without Pre-transplantation Bariatric Surgery: a Systematic Review.

Mousapour, P., et al.

Obesity Surgery 2022 [record in progress].


Aims
The aim of this study was to compare post-transplantation outcomes in morbidly obese patients that underwent bariatric surgery prekidney transplantation versus patients without bariatric surgery.

Interventions
Electronic databases including EMBASE, PubMed and Scopus were searched. Study selection and data extraction were performed by two independent reviewers. The methodological quality of the included studies was assessed using the Newcastle–Ottawa scale (NOS).

Participants
31 studies were included in the review.

Outcomes
The primary outcomes were kidney graft loss and patient mortality. The secondary outcomes included delayed graft function, acute rejection and posttransplantation complications.

Follow-up
N/A

CET Conclusions
This is a well-conducted systematic review; a protocol was registered in advance and the authors followed best practice guidance, multiple databases were searched, results were screened by two reviewers independently and data was extracted independently. A formal quality assessment of studies was completed using a recognised score (Newcastle-Ottawa). 31 studies were included in the review, the majority being cohort studies. The number of included patients with prior bariatric surgery was relatively small (148) versus the number of obese patients without prior bariatric surgery (2134). Similar rates of graft loss and patient death were recorded. Direct comparisons were not made as only 2 case-control studies were included. The level of evidence available is low, open to selection, reporting and publication bias.

Trial registration
PROSPERO - CRD42021224801

Funding source
Non-industry funded