Abstract
Obesity is considered a barrier for patients pursuing kidney transplantation because of its association with increased postoperative wound complications, delayed graft function, and reduced long-term graft survival. The incidence of obesity in patients with kidney failure is increasing, but the frequency of metabolic bariatric surgery (MBS) in patients receiving dialysis remains low owing to the perceived increased risk of complications. However, a meta-analysis comparing patients undergoing MBS in those receiving versus not receiving chronic dialysis showed that rates of complications including myocardial infarction (dialysis 0.5% versus general population 0.1%) and mortality (0.5 versus 0.1%) were low. The aim of this work was to characterize postoperative outcomes of patients on maintenance dialysis who underwent MBS in Australia and New Zealand over 15 years and to determine whether MBS was associated with higher rates of transplantation and better survival in patients on chronic dialysis compared with a matched group of chronic dialysis patients who did not undergo surgery.