肾移植患者的外科减肥程序
Surgery to Achieve Weight Loss and Qualify for a 肾移植
Increasing numbers of patients with end-stage renal disease are "morbidly obese," which means they weigh over 100 pounds more than their ideal body weight or they have a body mass index of 35 or higher. 身体质量指数, 或身体质量指数, is a number based on your height and weight that can help evaluate the degree to which you are overweight and assess your total body fat. 正常的BMI是20到25.
Morbid obesity puts transplant patients at greater risk for complications and is often a reason for deciding that a patient is not a candidate for a transplant. Some overweight patients who wish to have a kidney transplant are able to lose weight through diet and exercise in order to qualify for a transplant. 其他病人做不到这一点. 除了, many patients gain significant amounts of weight after their transplants and can develop serious medical conditions as a result of this weight gain.
The 减肥手术中心 at UCSF Medical Center can help patients lose weight and maintain that weight loss to improve overall health. 在等待肾脏移植的病人中, losing weight also can improve their chances of being a transplant candidate.
The procedure being performed most commonly at UCSF is the gastric bypass, which has been shown to be the most effective way for morbidly obese patients to lose weight.
- 该手术通常在腹腔镜下进行
- Most patients are able to go home two to three days after the surgery
- The surgeon performing this procedure in patients with kidney failure or in patients with transplants is also a transplant surgeon who is familiar with the special needs of these patients
在过去的几年里, we have examined the potential benefits of gastric bypass procedures in morbidly obese dialysis and transplant patients and found that this surgery can be performed safely and may be a life–saving procedure.
If you are interested in learning more, please visit the UCSF Bariatric Surgery 网站 或致电(415)353-3619联系UCSF减肥手术中心.
透析通路手术
病人 with end-stage renal disease who require dialysis need an easy-to-use entryway or "access" to the bloodstream for regular dialysis treatments to take place. The access is usually in your arm or leg and allows blood to be removed and returned quickly and safely during dialysis.
UCSF kidney transplant surgeons also specialize in creating permanent access for dialysis by surgically joining an artery to a vein. This lets the vein receive blood at high pressure, leading to thickening of the vein's wall. 一旦静脉壁增厚, it is strong enough to take the repeated puncture needed for dialysis treatment. It also provides excellent blood flow rates for effective dialysis. The connection between an artery and a vein can be made using blood vessels — an arteriovenous fistula, 或AVF,或“桥式”动静脉移植物, 或AVG.
The fistula is preferable because rates of infection are very low and it is quite sturdy. It may take many months for the fistula to grow strong enough to work correctly, 因此,周密的计划是必要的.
The graft can be used for dialysis access a few weeks after it is created. It provides good blood flow but has a higher complication rate than the fistula. A graft should be used only if it is not possible to create a fistula.
Another form of dialysis uses a plastic tube or catheter that exchanges fluid in the abdominal space. 这种形式的透析称为腹膜透析. UCSF surgeons have developed a way to place these catheters using small incisions and a scope. This allows for faster healing, and earlier use of the catheter.
糖尿病患者的选择
UCSF has been a national leader in pancreas and pancreas/kidney transplants in patients with 糖尿病 mellitus. Although these operations are more complex than solitary kidney transplants and require close post-operative follow-up, our patients have done extremely well and most continue to enjoy a life free of dialysis and insulin therapy.
除了胰腺移植, our center now also offers pancreatic islet transplantation to selected patients with difficult to control 糖尿病. This treatment is part of a trial sponsored by the National Institutes of Health. We have now performed islet transplants in four patients at our center.
如果您对这些选项中的任何一个感兴趣, we can provide you with the relevant information during your initial visit with us.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.