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Patients with a BMI over 40 have a new option for kidney transplantation

Feb. 8, 2022

Aurora, Colo. (Feb. 8, 2022) – After more than three years of intensive research and planning, UCHealth University of Colorado Hospital on the Anschutz Medical Campus has completed two successful robotic kidney transplants on patients with a body mass index (BMI) over 40.

“There are only a small handful of health care providers in the country who can perform robotic kidney transplants on larger patients with good outcomes,” said Dr. Elizabeth Pomfret, director of the UCHealth Transplant Center and chief of the CU School of Medicine division of transplant surgery. “We are thrilled that these patients now have the opportunity to receive a potentially life-saving transplant.”

According to the United Network for Organ Sharing (UNOS), as of September 2021, there were approximately 90,000 patients in the United States on dialysis waiting for a kidney transplant. As obesity has grown to affect 40% of the U.S. population and impacts almost 60% of patients seeking kidney transplant, BMI — a traditional transplant criterion — has become a barrier.

Patients with high BMIs are not typically transplanted in the U.S. because they are part of a high-risk population that experiences increased complications from the surgery. Many patients have comorbid conditions with obesity including diabetes, hypertension, arthritis, sleep apnea, increased cancer risk and infection rates. Most patients with high BMI also have increased visceral fat, which can elevate the risk for cardiac disease as well.

“It’s virtually impossible to ask a patient to lose 50 pounds when they’re tethered to a dialysis machine three times per week,” said Dr. Thomas Pshak, surgeon with the UCHealth Transplant Center and the lead on the robotic kidney transplant team. “One of the reasons the traditional transplant surgery is risky for larger patients is that it can be very difficult to see the vessels needed to ensure the kidney is properly placed. Robotics allows for 10 times greater vision, therefore allowing us to do the surgery regardless of BMI.”

Centennial, Colorado resident Jason Lang, 46, was diagnosed with polycystic kidney disease as a child and it had progressed to the point where he needed dialysis to help support his failing kidneys. Physicians had told Jason that he needed a kidney transplant, but because his BMI was over 40, a traditional transplant surgery was potentially too risky. Because of the new robotic surgery capabilities at UCHealth, Jason was able to get a new kidney last fall.

“I knew I was going to eventually end up on dialysis and need a kidney transplant,” Lang said. “I reached out to UCHealth to explore my options and while the waitlist is normally about six to seven years for my blood type, in my case it was done in five months, thanks to my phenomenal longtime girlfriend Lisa Matlock, who donated her kidney to me.”

The surgery, which took place in November 2021, was successful and Lang has made a strong recovery.

“Everything lined up with this patient and we felt he made an ideal candidate for our first robotic kidney transplant surgery,” said Dr. Pshak, who is also an assistant professor at the CU School of Medicine division of transplant surgery.

A second robotic transplant surgery with a similar, positive outcome was performed a month later.

“My goal is to be able to perform 50-60 surgeries a year using this method,” said Dr. Pshak. “I want to help patients who have been told they are not surgical candidates have an opportunity to live a longer, better life.”

To learn more about the UCHealth Transplant program, visit our website.

 

About UCHealth

UCHealth is an innovative, nonprofit health system that delivers the highest quality medical care with an excellent patient experience. UCHealth includes 25,000 employees, 12 acute-care full-service hospitals and hundreds of physicians across Colorado, southern Wyoming and western Nebraska. With University of Colorado Hospital on the CU Anschutz Medical Campus as its academic anchor and the only adult academic medical center in the region, UCHealth is dedicated to providing unmatched patient care in the Rocky Mountain West. Offering more than 150 clinic locations, UCHealth pushes the boundaries of medicine, providing advanced treatments and clinical trials and improving health through innovation.