Background

Bariatric surgery (BS) in thoracic transplant patients with obesity can potentially improve long term outcomes. However, there are no outcomes data after BS in cardiac and lung transplant recipients. We aimed to evaluate both peri-operative and long-term outcomes up to 2 years after BS in post thoracic transplant patients.

Methods

A retrospective, multi-institutional study was conducted using the TriNetX database. A total of 36 cardirac transplant recipients (CTR) and 12 lung transplant recipients (LTR), who underwent BS, were compared to a cohort of 21,911 CTR and 14,712 LTR, without BS. The cohorts were propensity matched to BMI over 35 kg/m2.

Results

Maintenance immunosuppression was similar in both CTR and LTR. None of the CTR developed DVT or PE within 2 years of BS. There were no CTR diagnosed with graft loss up to 2 years following BS. None of them developed surgical site infections or sepsis within 1 year. There was significantly higher incidence of hypertension up to 2 years following BS (p<0.05). None of them had abnormal cholesterol levels within 2 years. None of them developed acute coronary syndromes within 6-months. There were no LTR diagnosed with SSI, DVT or PE after BS up to 2-years. No LTR developed heart failure or graft loss. None of the LTR were using CPAP at the 6-month mark. None of the LTR developed acute coronary syndromes2-years.

Conclusions

Bariatric surgery for treatment of obesity following cardiac and lung transplantation is a safe procedure without significant risk of perioperative and long-term complications.