{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:07:54Z","timestamp":1787504874084,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Obesity affects over 40% of solid organ transplant candidates, increasing graft complications. Bariatric surgery remains underutilized in this population due to safety concerns. We sought to evaluate predictors of graft success among patients with and without a history of bariatric surgery. Methods: We utilized the Nationwide Inpatient Sample (2015\u20132020) to identify adult solid organ transplant recipients with or without a history of bariatric surgery. Propensity score matching (2:1) was performed. The primary outcome was a composite of graft-related complications, including acute or chronic rejection, graft failure, and organ-specific transplant complications. Results: Among 196,871 transplant recipients, 2670 (1.4%) had a bariatric surgery history. After matching, 2530 bariatric surgery patients (age 55.6 \u00b1 11.3 years, 37.5% female, 29.0% obese) were compared with 4817 controls (age 56.3 \u00b1 13.9 years, 36.0% female. 29.1% obese). Bariatric surgery patients had significantly lower composite graft complications (7.7% vs. 10.5%; p &lt; 0.001), driven by reductions in chronic graft rejection (2.1% vs. 3.1%; p = 0.01), kidney complications (6.2% vs. 8.4%; p &lt; 0.001), and pancreas complications (0.2% vs. 0.6%; p = 0.004). Multivariate analysis showed bariatric surgery was independently associated with 23% reduced odds of graft complications (OR 0.77; 95% CI 0.61\u20130.96; p = 0.02). Conclusions: Bariatric surgery was independently associated with reduced graft-related complications in solid organ transplant recipients, supporting its role in improving post-transplant outcomes. Future studies should define the optimal timing of bariatric surgery relative to transplantation.<\/jats:p>","DOI":"10.3390\/jcm15030954","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:21:40Z","timestamp":1769505700000},"page":"954","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Bariatric Surgery on Post-Transplant Outcomes in Solid Organ Recipients: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7148-5450","authenticated-orcid":false,"given":"Leandro","family":"Sierra","sequence":"first","affiliation":[{"name":"Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0856-7222","authenticated-orcid":false,"given":"Kanisha","family":"Bahierathan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ortega","family":"Abad","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roma","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Firkins","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Simons-Linares","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Loyola University Medical Center, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"GBD 2015 Obesity Collaborators (2017). Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N. Engl. J. Med., 377, 13\u201327.","DOI":"10.1056\/NEJMoa1614362"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4138","DOI":"10.1007\/s00464-024-10930-8","article-title":"Obesity, organ failure, and transplantation: A review of the role of metabolic and bariatric surgery in transplant candidates and recipients","volume":"38","author":"Ghanem","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"111315","DOI":"10.1016\/j.biopha.2021.111315","article-title":"Adipose tissue and insulin resistance in obese","volume":"137","author":"Ahmed","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"ref_4","first-page":"638936","article-title":"Obesity and surgical wound healing: A current review","volume":"2014","author":"Pierpont","year":"2014","journal-title":"ISRN Obes."},{"key":"ref_5","first-page":"e11720","article-title":"The Effect of Obesity on Operative Time and Postoperative Complications for Peritrochanteric Femur Fractures","volume":"12","author":"Schuette","year":"2020","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1159\/000304766","article-title":"Obesity\u2014A reluctance to treat?","volume":"3","author":"Hall","year":"2010","journal-title":"Obes. Facts"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/obr.12266","article-title":"Impact of weight bias and stigma on quality of care and outcomes for patients with obesity","volume":"16","author":"Phelan","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1111\/ajt.12331","article-title":"The survival benefit of kidney transplantation in obese patients","volume":"13","author":"Gill","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1007\/s11695-017-3104-9","article-title":"Systemic inflammation in severe obese patients undergoing surgery for obesity and weight-related diseases","volume":"28","author":"Freitas","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.jhep.2025.02.030","article-title":"Simultaneous liver transplant and sleeve gastrectomy provides durable weight loss, improves metabolic syndrome and reduces allograft steatosis","volume":"83","author":"Larson","year":"2025","journal-title":"J. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1016\/j.ajt.2024.07.024","article-title":"Economic evaluation of weight loss and transplantation strategies for kidney transplant candidates with obesity","volume":"24","author":"Puttarajappa","year":"2024","journal-title":"Am. J. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s11695-021-05684-4","article-title":"Clinical and economic impact of previous bariatric surgery on liver transplantation: A nationwide, population-based retrospective study","volume":"32","author":"Iannelli","year":"2022","journal-title":"Obes. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1080\/1744666X.2024.2421310","article-title":"Pathophysiology of rejection in kidney transplantation","volume":"20","author":"Cucchiari","year":"2024","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/j.soard.2019.04.002","article-title":"Bariatric surgery before and after kidney transplantation: Long-term weight loss and allograft outcomes","volume":"15","author":"Cohen","year":"2019","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1111\/ajt.14463","article-title":"Laparoscopic sleeve gastrectomy improves renal transplant candidacy and posttransplant outcomes in morbidly obese patients","volume":"18","author":"Kim","year":"2018","journal-title":"Am. J. Transplant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/ajt.16856","article-title":"Taurodeoxycholic acid and valine reverse obesity-associated augmented alloimmune responses and prolong allograft survival","volume":"22","author":"Quante","year":"2022","journal-title":"Am. J. Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jss.2021.12.029","article-title":"Is bariatric procedure type associated with morbidity in transplant patients?","volume":"273","author":"Fagenson","year":"2022","journal-title":"J. Surg. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.jss.2024.05.007","article-title":"Outcomes of Sleeve Gastrectomy in Patients with Organ Transplant-Related Immunosuppression","volume":"300","author":"Zevallos","year":"2024","journal-title":"J. Surg. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2772","DOI":"10.1111\/ajt.14739","article-title":"Bariatric surgery in solid organ transplant patients: Long-term follow-up results of outcome, safety, and effect on immunosuppression","volume":"18","author":"Yemini","year":"2018","journal-title":"Am. J. Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Humi\u0119cka, M., Sawicka, A., K\u0119dzierska, K., Binda, A., Jaworski, P., Tarnowski, W., and Jankowski, P. (2025). Prevalence of nutrient deficiencies following bariatric surgery-long-term, prospective observation. Nutrients, 17.","DOI":"10.3390\/nu17162599"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jamcollsurg.2013.10.023","article-title":"Incidence, treatment, and outcomes of iron deficiency after laparoscopic Roux-en-Y gastric bypass: A 10-year analysis","volume":"218","author":"Obinwanne","year":"2014","journal-title":"J. Am. Coll. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s11154-017-9418-z","article-title":"Current evidence on vitamin D deficiency and kidney transplant: What\u2019s new?","volume":"18","author":"Sarno","year":"2017","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101410","DOI":"10.1016\/j.trim.2021.101410","article-title":"The association between vitamin D and acute rejection in human kidney transplantation: A systematic review and meta-analysis study","volume":"67","author":"Mirzakhani","year":"2021","journal-title":"Transpl. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.soard.2019.10.025","article-title":"Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures\u20142019 update: Cosponsored by American Association of Clinical Endocrinologists\/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists","volume":"16","author":"Mechanick","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.soard.2016.12.018","article-title":"American Society for Metabolic and bariatric surgery integrated health nutritional guidelines for the surgical weight loss patient 2016 update: Micronutrients","volume":"13","author":"Parrott","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3111","DOI":"10.1007\/s11695-025-08007-z","article-title":"In-Hospital Outcomes of Bariatric Surgery in People Living with HIV: A Nationwide Analysis","volume":"35","author":"Sierra","year":"2025","journal-title":"Obes. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S2468-1253(20)30302-2","article-title":"Adaptations in gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass","volume":"6","author":"Steenackers","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1111\/obr.12869","article-title":"The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review","volume":"20","author":"Angeles","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/j.1399-0012.2007.00783.x","article-title":"Pharmacokinetics of mycophenolic acid, tacrolimus and sirolimus after gastric bypass surgery in end-stage renal disease and transplant patients: A pilot study","volume":"22","author":"Rogers","year":"2008","journal-title":"Clin. Transplant."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"528","DOI":"10.2215\/CJN.07670715","article-title":"Is Bariatric Surgery an Effective Treatment for Type II Diabetic Kidney Disease?","volume":"11","author":"Friedman","year":"2016","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1016\/j.soard.2020.05.012","article-title":"Bariatric surgery before, during, and after liver transplantation: A systematic review and meta-analysis","volume":"16","author":"Lee","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"4125","DOI":"10.1007\/s11695-023-06898-4","article-title":"The Effect of Bariatric Surgery on Patients with Heart Failure: A Systematic Review and Meta-analysis","volume":"33","author":"Esparham","year":"2023","journal-title":"Obes. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/954\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:37:55Z","timestamp":1769506675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/954"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15030954"],"URL":"https:\/\/doi.org\/10.3390\/jcm15030954","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]}}}