Loyola Medicine Improves Health Equity by Increasing Access to Kidney Transplants for Patients with Obesity

MAYWOOD, IL – Diabetes and high blood pressure are among the primary causes of renal failure. They also contribute to obesity which poses a major obstacle to qualifying for a transplant, particularly for minority communities disproportionately affected by obesity. Fortunately, minimally invasive robotic surgical technology can improve access for patients who might otherwise be ineligible for a kidney transplant. Loyola Medicine's advanced robotic surgery program makes it one of the few hospitals in the country to offer kidney transplantation to patients with obesity.

Raquel Garcia-Roca, MD, surgical director of the kidney, pancreas and living donor kidney transplant programs, said, "in the majority of the transplant centers, not only here in Chicago, but nationwide, there is limited access to transplantation when the patient's body mass index is above 35, an indication of obesity." Patients with high BMIs are typically ruled ineligible for transplantation due to the increased risk of complications that comes with obesity and its comorbid conditions, including increased infection rates.

However, the advanced technology of robotic surgery allows surgeons to operate using keyhole surgery, which improves outcomes with faster recovery and reduced infection risk compared with open surgery. "Most transplant centers will ask potential kidney recipients to lose weight before they can get a transplant," said Garcia-Roca. "This can be difficult for patients who already have limited dietary options due to their renal disease and whose condition often makes it hard to exercise. Loyola is one of the very few centers in the nation that has not included obesity as a limitation for transplantation."

Dr. Garcia-Roca says the ability to provide transplants for patients with obesity helps improve health equity in minority communities disproportionately affected by obesity. According to the CDC, non-Hispanic Black adults had the highest age-adjusted prevalence of obesity (49.9%), followed by Hispanic adults (45.6%) and non-Hispanic White adults (41.4%).

Loyola's ability to perform transplants for patients with obesity proved to be lifesaving for Israel Sanchez, a patient with end-stage renal failure. When Sanchez was a child living in Mexico, he developed an infection that damaged his kidneys. At age 12, he came to the United States, and at 21 years old, he was told he would need a kidney transplant and hemodialysis in the next few years.

At 216 pounds, and having experienced lifelong symptoms, Sanchez thought there were no further options. But five years after he began dialysis, he sought treatment at Loyola Medicine. With a BMI of 42, he might have been turned away from another center, but was able to receive a transplant at Loyola. Sanchez described finding out about the transplant as one of the happiest days of his life. "I felt, this is unbelievable," said Sanchez. "This is probably a dream. This is impossible that it's happening to me."

Sanchez also said he felt most comfortable with Loyola because so many people on the transplant team spoke Spanish. More than half of Loyola Medicine's abdominal transplant team are Spanish speakers, including surgeons, nurses, social workers and transplant coordinators of Hispanic origin. Dr. Garcia-Roca said, "we also work around a lot of the barriers to access that make it very difficult for members of the Hispanic community to reach a transplant center."

Since his surgery and recovery, Sanchez has lost around 30 pounds. He says he's motivated to eat healthier and has the energy to work out and take walks outside. "It's things that I haven’t experienced that people take for granted that I want to do," Sanchez said. "I'm just grateful for this opportunity that I have to experience a life that I never experienced."

Dr. Garcia-Roca is encouraged by his progress. "Israel has made huge, huge changes in his life and lost a lot of weight. This is all super beneficial because he will maintain a very good, healthy condition for this new kidney to continue to work for a very long time."

To watch a video about Israel Sanchez's journey and robotic transplant technology at Loyola, click this link. B-roll of Mr. Sanchez and Dr. Garcia-Roca is available to download here. B-roll with additional conversations in Spanish is available here.