Metabolic and Bariatric Surgery (MBS) in increasingly performed in patients with previous solid organ transplantation (PSOT). There also remains controversy about whether racial disparity in outcomes following MBS exists. Little is known about outcomes in MBS racial cohorts who have PSOT. Our aim was to determine if race independently predict outcomes in MBS patients with PSOT.
We performed a retrospective analysis of the 2017 Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. We included Sleeve Gastrectomy (SG) and Roux-en-Y gastric bypass (RnYGB) patients. Selected cases were stratified by race, comparing non-Hispanic Black and non-Hispanic White patients. Outcomes were compared by Mann-U-Whitney, Chi-square Test and Multivariable Logistic Regression (MLR) analysis.
Of 614 MBS cases with PSOT in the 2017 MBSAQIP database, we analyzed 297, including 220 (74%) White and 77 (26%) Black patents. Procedure-type (p = 0.66) and surgical approach (p = 0.55) were similarly distributed. Black patients were more likely to have an ASA >3, hypertension, an IVC filter, be on chronic steroid (p = 0.03) and dialysis-dependent (Table 1). There were no significant differences in outcomes, except a 3-fold higher rate of ED visits in Black patients (p = 0.004). Black patients had non-significantly higher rates of morbidity, 30-day adverse outcomes, VTE, and aggregate pulmonary and renal complications.
MBS in racial cohorts with PSOT is safe, with very low rates of morbidity and mortality. Black race was not an independent predictor of outcomes. Larger cohort studies are needed to validate our findings.