Background

Diabetes mellitus (DM) is frequently present in Metabolic and Bariatric Surgery (MBS) patients and is independently associated with increased morbidity. Organ transplantation patients also suffer from severe obesity and are now increasingly undergoing MBS. Our aim was to determine if DM independently impact perioperative outcomes following MBS in previous solid organ transplantation patients.

Methods

A retrospective analysis was performed of Sleeve Gastrectomy (SG) and Roux-en-Y gastric bypass (RnYGB) patients in the 2017 Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. Patients with a history of solid organ transplantation were identified and stratified by Diabetes Mellitus status. Outcomes were compared by Mann-U-Whitney, Chi-square Test and Multivariable Logistic Regression (MLR) analysis.

Results

Of 614 MBS cases with prior organ transplantation in the MBSAQIP database, 338 were analysis, including 132 (39%) with and 206 (61%) without DM. Patients with DM were more likely to be male (p < 0.001), with a history of cardiac surgery (0.002), hypertension (p < 0.001), hyperlipidemia (p < 0.001), obstructive sleep apnea (p < 0.001), and have less independent functional status (p = 0.01). There was no significant difference in morbidity, mortality and aggregate complications between DM and no DM study cohorts. In MLR analysis, DM was not predictive of adverse outcomes (Table 1).

Conclusions

MBS in Diabetic patients with previous solid organ transplantation is overall safe, with low rates of morbidity and mortality. Diabetes was not an independent predictor of adverse outcomes in this cohort of patients. Larger cohort studies are needed.