Clinical outcomes in solid organ transplant recipients undergoing Roux-en-Y gastric bypass surgery: a propensity score-matched study
In brief
Transplant recipients had similar early bypass outcomes but more late complications
In this matched study, 17 transplant recipients had early complication and readmission rates and 6- and 12-month weight loss outcomes similar to 51 nontransplant patients after gastric bypass. Over longer follow-up, transplant recipients had less time without late complications or reoperation and lower overall survival. The small, retrospective study underscores the need for close long-term follow-up.
- Journal
- Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Q1)
- Published
- 21 September 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Tamar Tsenteradze, Steven P Bowers, Enrique F Elli
- PMID
- 42875323
- DOI
- 10.1016/j.soard.2026.09.015
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 16 October 2026): Clinical outcomes in solid organ transplant recipients undergoing Roux‑en‑Y gastric
Abstract
BACKGROUND: The safety and efficacy of bariatric surgery in solid organ transplant recipients remain incompletely understood because of chronic immunosuppression and increased medical complexity. OBJECTIVES: This study evaluated perioperative outcomes, long-term morbidity, and weight loss following Roux-en-Y gastric bypass (RYGB) in transplant recipients compared with matched nontransplant patients. SETTING: Tertiary academic medical center, United States. METHODS: A retrospective review of a prospectively maintained database identified 566 patients who underwent primary robotic RYGB between January 2014 and December 2024. Seventeen solid organ transplant recipients receiving chronic immunosuppressive therapy were identified and matched 3:1 to nontransplant patients using propensity scores based on age, body mass index, and obesity-related co-morbidities. Perioperative outcomes, postoperative complications, readmissions, reinterventions, survival, and weight loss outcomes were compared. RESULTS: After propensity score matching, 68 patients were included (17 transplant recipients and 51 nontransplant patients). Baseline demographic and clinical characteristics were comparable between groups. Early postoperative outcomes did not differ significantly, including complications (41.2% versus 27.5%, P = .29), readmissions (35.3% versus 25.5%, P = .44), and reinterventions (.0% versus 7.8%, P = .23). Observed late complication, readmission, and reoperation proportions were higher among transplant recipients. Kaplan-Meier analysis demonstrated lower freedom from late complications (log rank P = .006), lower freedom from late reoperation (log rank P = .010), and lower overall survival (log rank P = .029). Weight loss outcomes were comparable between groups, with no significant differences in body mass index reduction or total body weight loss at 6 or 12 months. CONCLUSIONS: RYGB demonstrated comparable early perioperative safety and short-term weight loss outcomes in solid organ transplant recipients and matched nontransplant patients. However, transplant recipients experienced higher rates of late complications, readmissions, and reinterventions, emphasizing the importance of close multidisciplinary follow-up and long-term surveillance in this high-risk population.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.