Organ transplantation and obesity: Evaluation, risks and benefits of therapeutic strategies

Obesity is a prevalent health problem that has discernible impact on all fi elds of surgery. However, little attention is paid in the literature to the underlying relation of surgical, immunological and metabolic links between transplantation and morbid obesity. Pre-operative obesity has been reporte d to worsen the outcome of organ transplantation. Impairment of graft funct ion as well as decreased patient and graft survival can contribute to this effect. Post-transplant weight gain is common and may be attributed to an i mbalance of the adipostatic and appetite stimulating hormones. Reduction of obesity before transplantation has to cope with limited time, increased ri sk of therapeutic side-effects in patients with end-stage organ failure, an d psychosocial stress. Overweight reduction following organ transplantation interferes with diverse effects associated with immunosuppressive therapy. A case of adjustable gastric banding following renal transplantation is pr esented.