Bariatric Surgery Outcomes in Patients with Prior Solid Organ Transplantation: an MBSAQIP Analysis
Introduction Obesity is a risk factor for poor patient outcomes after organ transplantation (TXP). While metabolic and bariatric surgery (MBS) is safe and effective in treating severe obesity, the role of MBS in transplant patients continues to evolve. Methods A retrospective analysis was performed...
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| Veröffentlicht in: | Obesity surgery 2020-06, Vol.30 (6), p.2313-2324 |
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| creator | Fagenson, Alexander M. Mazzei, Michael M. Zhao, Huaqing Lu, Xiaoning Edwards, Michael A. |
| description | Introduction
Obesity is a risk factor for poor patient outcomes after organ transplantation (TXP). While metabolic and bariatric surgery (MBS) is safe and effective in treating severe obesity, the role of MBS in transplant patients continues to evolve.
Methods
A retrospective analysis was performed of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients in the 2017 Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. Propensity and case-control matching, and multivariable logistic regression were performed for 30-day post-operative outcomes.
Results
A total of 336 transplant patients were compared with 157,413 patients without transplant. Propensity and case-control matching reveal no significant differences in mortality (
p
> 0.2). However, case-control matching revealed longer operative time (104 min versus 76 min,
p
|
| doi_str_mv | 10.1007/s11695-020-04490-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7222903</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2364047930</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-ec3a519070cd922c417336e0966f7f583f02740890a457abcec07d85b9a98483</originalsourceid><addsrcrecordid>eNp9kUtPGzEUha2qFaTAH-iistRNN1OuHzO2WVQKqA8kUFIle8txPMFoYgd7pij_HqehULpgZfnez8fn6CD0gcAXAiBOMyGNqiugUAHnCir5Bo2IAFmuVL5FI1BNGSrKDtH7nG8BKGkoPUCHjO5WhI_Q4twkb_rkLZ4NaeXSFk-G3sa1y9gHPDW9d6HP-N73N3iafEx4Fju_xJO0MgHPkwl505nQFzCGM1xm1-ez8a_LKR4H022zz8foXWu67E4ezyM0__5tfvGzupr8uLwYX1WWC95XzjJTEwUC7FJRajkRjDWuGG1a0daStUAFB6nA8FqYhXUWxFLWC2WU5JIdoa972c2wWLulLbaT6fQm-bVJWx2N1y83wd_oVfytBaVUASsCnx8FUrwbXO712mfrupLOxSFryhoOXCgGBf30H3obh1Ty7qjipghKVSi6p2yKOSfXPpkhoHcN6n2DujSo_zSodzE-_hvj6cnfygrA9kAuq1Aae_77FdkH3kKmQg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2398422989</pqid></control><display><type>article</type><title>Bariatric Surgery Outcomes in Patients with Prior Solid Organ Transplantation: an MBSAQIP Analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Fagenson, Alexander M. ; Mazzei, Michael M. ; Zhao, Huaqing ; Lu, Xiaoning ; Edwards, Michael A.</creator><creatorcontrib>Fagenson, Alexander M. ; Mazzei, Michael M. ; Zhao, Huaqing ; Lu, Xiaoning ; Edwards, Michael A.</creatorcontrib><description>Introduction
Obesity is a risk factor for poor patient outcomes after organ transplantation (TXP). While metabolic and bariatric surgery (MBS) is safe and effective in treating severe obesity, the role of MBS in transplant patients continues to evolve.
Methods
A retrospective analysis was performed of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients in the 2017 Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. Propensity and case-control matching, and multivariable logistic regression were performed for 30-day post-operative outcomes.
Results
A total of 336 transplant patients were compared with 157,413 patients without transplant. Propensity and case-control matching reveal no significant differences in mortality (
p
> 0.2). However, case-control matching revealed longer operative time (104 min versus 76 min,
p
< 0.001), increased length of stay (2 days versus 1 day,
p
< 0.05), perioperative transfusions (2% versus 0.22%,
p
= 0.009), and leak rates (2.2% versus 0.55%,
p
= 0.02) in the transplant cohort. On multivariable regression analysis, prior transplantation was associated with higher rates of overall (OR 1.6,
p
= 0.007) and bariatric-related morbidity (OR 1.78,
p
= 0.004), leak (OR 3.47,
p
= 0.0027), and surgical site infection (OR 3.32,
p
= 0.004). Prior transplantation did not predict overall (
p
= 0.55) nor bariatric-related mortality (
p
= 0.99).
Conclusion
MBS in prior solid organ transplantation patients is overall safe, but is associated with increased operative time and length of stay, as well as higher rates of some post-operative morbidity.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-020-04490-8</identifier><identifier>PMID: 32096014</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Accreditation ; Bariatric Surgery ; Gastrointestinal surgery ; Humans ; Medicine ; Medicine & Public Health ; Metabolism ; Mortality ; Obesity, Morbid - surgery ; Organ Transplantation ; Original Contributions ; Retrospective Studies ; Surgery ; Transplants & implants ; Treatment Outcome</subject><ispartof>Obesity surgery, 2020-06, Vol.30 (6), p.2313-2324</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-ec3a519070cd922c417336e0966f7f583f02740890a457abcec07d85b9a98483</citedby><cites>FETCH-LOGICAL-c474t-ec3a519070cd922c417336e0966f7f583f02740890a457abcec07d85b9a98483</cites><orcidid>0000-0003-4811-0789</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-020-04490-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-020-04490-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32096014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fagenson, Alexander M.</creatorcontrib><creatorcontrib>Mazzei, Michael M.</creatorcontrib><creatorcontrib>Zhao, Huaqing</creatorcontrib><creatorcontrib>Lu, Xiaoning</creatorcontrib><creatorcontrib>Edwards, Michael A.</creatorcontrib><title>Bariatric Surgery Outcomes in Patients with Prior Solid Organ Transplantation: an MBSAQIP Analysis</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Introduction
Obesity is a risk factor for poor patient outcomes after organ transplantation (TXP). While metabolic and bariatric surgery (MBS) is safe and effective in treating severe obesity, the role of MBS in transplant patients continues to evolve.
Methods
A retrospective analysis was performed of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients in the 2017 Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. Propensity and case-control matching, and multivariable logistic regression were performed for 30-day post-operative outcomes.
Results
A total of 336 transplant patients were compared with 157,413 patients without transplant. Propensity and case-control matching reveal no significant differences in mortality (
p
> 0.2). However, case-control matching revealed longer operative time (104 min versus 76 min,
p
< 0.001), increased length of stay (2 days versus 1 day,
p
< 0.05), perioperative transfusions (2% versus 0.22%,
p
= 0.009), and leak rates (2.2% versus 0.55%,
p
= 0.02) in the transplant cohort. On multivariable regression analysis, prior transplantation was associated with higher rates of overall (OR 1.6,
p
= 0.007) and bariatric-related morbidity (OR 1.78,
p
= 0.004), leak (OR 3.47,
p
= 0.0027), and surgical site infection (OR 3.32,
p
= 0.004). Prior transplantation did not predict overall (
p
= 0.55) nor bariatric-related mortality (
p
= 0.99).
Conclusion
MBS in prior solid organ transplantation patients is overall safe, but is associated with increased operative time and length of stay, as well as higher rates of some post-operative morbidity.</description><subject>Accreditation</subject><subject>Bariatric Surgery</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolism</subject><subject>Mortality</subject><subject>Obesity, Morbid - surgery</subject><subject>Organ Transplantation</subject><subject>Original Contributions</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtPGzEUha2qFaTAH-iistRNN1OuHzO2WVQKqA8kUFIle8txPMFoYgd7pij_HqehULpgZfnez8fn6CD0gcAXAiBOMyGNqiugUAHnCir5Bo2IAFmuVL5FI1BNGSrKDtH7nG8BKGkoPUCHjO5WhI_Q4twkb_rkLZ4NaeXSFk-G3sa1y9gHPDW9d6HP-N73N3iafEx4Fju_xJO0MgHPkwl505nQFzCGM1xm1-ez8a_LKR4H022zz8foXWu67E4ezyM0__5tfvGzupr8uLwYX1WWC95XzjJTEwUC7FJRajkRjDWuGG1a0daStUAFB6nA8FqYhXUWxFLWC2WU5JIdoa972c2wWLulLbaT6fQm-bVJWx2N1y83wd_oVfytBaVUASsCnx8FUrwbXO712mfrupLOxSFryhoOXCgGBf30H3obh1Ty7qjipghKVSi6p2yKOSfXPpkhoHcN6n2DujSo_zSodzE-_hvj6cnfygrA9kAuq1Aae_77FdkH3kKmQg</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Fagenson, Alexander M.</creator><creator>Mazzei, Michael M.</creator><creator>Zhao, Huaqing</creator><creator>Lu, Xiaoning</creator><creator>Edwards, Michael A.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4811-0789</orcidid></search><sort><creationdate>20200601</creationdate><title>Bariatric Surgery Outcomes in Patients with Prior Solid Organ Transplantation: an MBSAQIP Analysis</title><author>Fagenson, Alexander M. ; Mazzei, Michael M. ; Zhao, Huaqing ; Lu, Xiaoning ; Edwards, Michael A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-ec3a519070cd922c417336e0966f7f583f02740890a457abcec07d85b9a98483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Accreditation</topic><topic>Bariatric Surgery</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolism</topic><topic>Mortality</topic><topic>Obesity, Morbid - surgery</topic><topic>Organ Transplantation</topic><topic>Original Contributions</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fagenson, Alexander M.</creatorcontrib><creatorcontrib>Mazzei, Michael M.</creatorcontrib><creatorcontrib>Zhao, Huaqing</creatorcontrib><creatorcontrib>Lu, Xiaoning</creatorcontrib><creatorcontrib>Edwards, Michael A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fagenson, Alexander M.</au><au>Mazzei, Michael M.</au><au>Zhao, Huaqing</au><au>Lu, Xiaoning</au><au>Edwards, Michael A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bariatric Surgery Outcomes in Patients with Prior Solid Organ Transplantation: an MBSAQIP Analysis</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>30</volume><issue>6</issue><spage>2313</spage><epage>2324</epage><pages>2313-2324</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Introduction
Obesity is a risk factor for poor patient outcomes after organ transplantation (TXP). While metabolic and bariatric surgery (MBS) is safe and effective in treating severe obesity, the role of MBS in transplant patients continues to evolve.
Methods
A retrospective analysis was performed of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients in the 2017 Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. Propensity and case-control matching, and multivariable logistic regression were performed for 30-day post-operative outcomes.
Results
A total of 336 transplant patients were compared with 157,413 patients without transplant. Propensity and case-control matching reveal no significant differences in mortality (
p
> 0.2). However, case-control matching revealed longer operative time (104 min versus 76 min,
p
< 0.001), increased length of stay (2 days versus 1 day,
p
< 0.05), perioperative transfusions (2% versus 0.22%,
p
= 0.009), and leak rates (2.2% versus 0.55%,
p
= 0.02) in the transplant cohort. On multivariable regression analysis, prior transplantation was associated with higher rates of overall (OR 1.6,
p
= 0.007) and bariatric-related morbidity (OR 1.78,
p
= 0.004), leak (OR 3.47,
p
= 0.0027), and surgical site infection (OR 3.32,
p
= 0.004). Prior transplantation did not predict overall (
p
= 0.55) nor bariatric-related mortality (
p
= 0.99).
Conclusion
MBS in prior solid organ transplantation patients is overall safe, but is associated with increased operative time and length of stay, as well as higher rates of some post-operative morbidity.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32096014</pmid><doi>10.1007/s11695-020-04490-8</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-4811-0789</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Obesity surgery, 2020-06, Vol.30 (6), p.2313-2324 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Accreditation Bariatric Surgery Gastrointestinal surgery Humans Medicine Medicine & Public Health Metabolism Mortality Obesity, Morbid - surgery Organ Transplantation Original Contributions Retrospective Studies Surgery Transplants & implants Treatment Outcome |
| title | Bariatric Surgery Outcomes in Patients with Prior Solid Organ Transplantation: an MBSAQIP Analysis |
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