Expert: John Pilcher, MD - 8/28/2008

Question
Hello Dr.Pilcher,

I received a kidney transplant about 6 years ago and I haven't had any problems whatsoever aside from the weight gain from prednisone. My dosage is 5mg daily and I think I've topped out at my current weight. I would like to have the Lap Band surgery as the weight is causing other health problems now-mainly back and knee. Do you think this would be a good choice for me even though I must continue with prednisone? I desperately need to loose weight as it affects my livelihood. I've been researching and am not ok with the more invasive surgery techniques and side effects. My insurance has approved me for surgery, which should I look into?

Answer
Kenya,
First, let me endorse the conclusion you've reached that it IS reasonable to consider bariatric surgery after kidney transplant (assuming your BMI is greater than 35).  Your continued requirement to take prednisone 5 mg per day is a challenge, but in my opinion it is not an insurmountable one.

I think you are asking which procedure you ought to have done.  I would lean a bit toward Band but I would not rule out gastric bypass in case there is some advantage there (for example, if you have diabetes).  The key thing as you go forward will be to make the decision with the help of a surgeon who  practices at the level of a Center of Excellence.  You can find a listing of surgeons on our national website:

www.asmbs.org

Best of luck!
Dr JP