Gastric ‘Sleeve’ Surgery Removes Barriers to Kidney Transplant for Patient

Larry Barton, 63, Lexington, Ky., resident, keeps busy. Church, golfing, camping, hunting and the Corvette club—he does a lot.

That wasn’t quite the case a year ago when Barton, who endured a number of medical issues, visited the University of Kentucky to ask about a kidney transplant.

“I had a quadruple bypass in 2005 and had a mini-stroke after that,” he says, adding that a cyst was also found on his spine which was treated with high doses of antibiotics. “In addition, I had diabetes and was eventually put on dialysis.

“With all of these issues, I weighed about 313 pounds.”

Traditionally, physicians do not conduct transplant surgery on patients with a Body Mass Index (BMI) of 35 or more. Barton, unfortunately, had a BMI of 40.

“They told me to lose 60 pounds and then come back to see them,” he said. “That’s not as easy as it sounds.”

Barton’s nephrologist in Kentucky, Ashutosh Lohe, MD, referred him to Amit Govil, MD, UC Health nephrologist who started the UC Health Nephrology transplant outreach clinic initiative in Lexington more than three years ago—and he had a solution.

“The mission of our outreach clinics (there is also one in Lima, Ohio) is to help all patients overcome the barriers to a successful kidney transplant, and we have been able to make that impact in the region,” Govil says.

“Dr. (Tayyab) Diwan, a surgeon at University of Cincinnati Medical Center (UCMC), had just begun performing a new procedure in which obese patients undergo a sleeve gastrectomy first, lose the weight needed and then undergo the transplant procedure. Larry was the perfect candidate.”

Sleeve gastrectomy, or gastric sleeve, is a weight-loss procedure in which the stomach is reduced to about 25 percent of its original size by surgical removal of a large portion of the stomach following the major curve. The open edges are then attached to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach.

“I talked to Dr. Diwan and Dr. (E. Steve) Woodle who really made me feel confident about the surgery, even though they hadn’t done many cases yet,” Barton says.

He had the gastric sleeve in February 2012; by July, he had lost 65 pounds and was eligible for the transplant surgery.

“I have a wonderful friend, Merry Church, who was willing to give me one of her kidneys,” he says. “She was already tested, and we were a perfect match, so I was ready.”

Successful Transplant, Successful Weight Maintenance
Barton received his new kidney on July 17, 2012, and from that day, his life has improved tremendously.

“I’ve lost at total of 80 pounds—I’ve got 25 more to go to make my goal of 210 pounds—and I feel great; I feel like I’m 40 again,” he says, adding that his new kidney is great too, and that he’s been taken off of some of his immunosuppression drugs.

“I have great praise to give to Dr. Govil, Dr. Diwan and Dr. Woodle—as well as the rest of the team at UC. I’ve never been treated better, and I’ve been in and out of hospitals for the last seven years,” says Barton. “Everyone went out of their way to help—from the doctors to the nurses. You just don’t see that type of care anywhere. They weren’t just super health care providers—they were super people, and they gave me a new life.”

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