{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:19:36Z","timestamp":1791386376972,"version":"4.3.3"},"reference-count":48,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T00:00:00Z","timestamp":1523318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2018,5]]},"abstract":"Abstract<\/jats:title>\n \n Body mass index (\n BMI<\/jats:styled-content>\n )\u00a0>\u00a035\u201040\u00a0kg\/m\n 2<\/jats:sup>\n is often a contraindication, while Roux\u2010en\u2010Y gastric bypass (\n RYGB<\/jats:styled-content>\n ) is performed to enable kidney transplantation. This single\u2010center retrospective study evaluated pre\u2010 and post\u2010transplant outcomes of 31 morbidly obese patients with end\u2010stage renal disease having\n RYGB<\/jats:styled-content>\n before kidney transplantation between July 2009 and June 2014. Fourteen\n RYGB<\/jats:styled-content>\n patients were subsequently transplanted. Nineteen recipients not having\n GB<\/jats:styled-content>\n with a\n BMI<\/jats:styled-content>\n \u00a0\u2265\u00a036\u00a0kg\/m\n 2<\/jats:sup>\n at transplantation were used as historical controls. Mean\n BMI<\/jats:styled-content>\n (\u00b1\n SE<\/jats:styled-content>\n ) before\n RYGB<\/jats:styled-content>\n was 43.5\u00a0\u00b1\u00a00.7\u00a0kg\/m\n 2<\/jats:sup>\n (range: 35.4\u201050.5\u00a0kg\/m\n 2<\/jats:sup>\n ); 87.1% (27\/31) achieved a\n BMI<\/jats:styled-content>\n \u00a0<\u00a035\u00a0kg\/m\n 2<\/jats:sup>\n . The percentage having improved diabetes\/hypertension control was 29.0% (9\/31); 25.8% (8\/31) had complications (mostly minor) after\n RYGB<\/jats:styled-content>\n . Among transplanted patients, blacks\/Hispanics comprised 78.6% (11\/14) and 84.2% (16\/19) of\n RYGB<\/jats:styled-content>\n and controls; 57.1% (8\/14) and 63.2% (12\/19) had a (mostly long\u2010standing) pretransplant history of diabetes. While biopsy\u2010proven acute rejection (\n BPAR<\/jats:styled-content>\n ) occurred significantly higher among\n RYGB<\/jats:styled-content>\n vs control patients (6\/14 vs 3\/19,\n P\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n .03), patients developing T\u2010cell\n BPAR<\/jats:styled-content>\n were also significantly more likely to have a tacrolimus (\n TAC<\/jats:styled-content>\n ) trough level\u00a0<\u00a04.0\u00a0ng\/mL within 3\u00a0weeks of T\u2010cell\n BPAR<\/jats:styled-content>\n (\n P\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n .0007). In Cox's model, the impact of having a\n TAC<\/jats:styled-content>\n level\u00a0<\u00a04.0\u00a0ng\/mg remained significant (\n P\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n .007) while the effect of\n RYGB<\/jats:styled-content>\n was no longer significant (\n P\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n .13). Infections, graft, and patient survival were not significantly different. Despite obvious effectiveness in achieving weight loss,\n RYGB<\/jats:styled-content>\n will need more careful post\u2010transplant monitoring given the observed higher\n BPAR<\/jats:styled-content>\n rate.\n <\/jats:p>","DOI":"10.1111\/ctr.13232","type":"journal-article","created":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T08:22:48Z","timestamp":1519806168000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Roux\u2010en\u2010Y gastric bypass is an effective bridge to kidney transplantation: Results from a single center"],"prefix":"10.1111","volume":"32","author":[{"given":"Ian A.","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Medicine University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-7509","authenticated-orcid":false,"given":"Jeffrey J.","family":"Gaynor","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tameka","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor","family":"De La Cruz\u2010Munoz","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichiro","family":"Sageshima","sequence":"additional","affiliation":[{"name":"Department of Surgery UC Davis Medical Center Sacramento CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren","family":"Kupin","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Ciancio","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"George W.","family":"Burke","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela D.","family":"Mattiazzi","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giselle","family":"Guerra","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Miami\/Jackson Memorial Hospital Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,10]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","first-page":"3","article-title":"The evaluation of renal transplantation candidates: clinical practice guidelines","volume":"1","author":"Kasiske BL","year":"2001","journal-title":"Am J Transplant"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912023412303"},{"key":"e_1_2_7_4_1","unstructured":"World Health Organization.Obesity: preventing and managing the global epidemic. 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