How weight loss surgery is making his kidney transplant possible

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Todd Gomez


Todd Gomez is in need of a kidney transplant. The Denham Springs native has lived with chronic renal failure for more than four years, a diagnosis that keeps him on daily dialysis treatments. His doctors told him he wasn’t eligible for a life-altering kidney transplant because of his weight. At that time, the 53-year-old weighed 305 pounds.

“I had lost 50 pounds on my own at one point, but I kept gaining it back,” said Gomez. “I needed help. So that’s when I looked into having weight loss surgery.”

Because of his condition, Gomez was considered a high-risk patient for weight loss surgery. He met with Dr. Kenneth Kleinpeter, a general surgeon with The Surgeons Group of Baton Rouge at Our Lady of the Lake. Kleinpeter was familiar with Gomez’s case, having implanted the peritoneal dialysis (PD) catheter for Gomez’s dialysis treatments in 2013. He wanted to find a way to help Gomez with a successful bariatric surgery.

“The intersection of these cases is pretty rare,” said Dr. Kleinpeter. “He’s probably only one of handful of these patients in the country and the first in our area to have this weight loss procedure with a PD catheter.”

To remove and replace Gomez’s PD catheter would have required an additional surgery, something Dr. Kleinpeter wanted to avoid. Leaving the PD catheter in place, however, presented challenges around operating with the presence of a foreign body that could potentially increase the risk of infection.

Dr. Kleinpeter made the judgment call to leave the catheter in place. He temporarily stopped the PD treatments in favor of having Gomez undergo hemodialysis, a different type of treatment that required daily clinic visits. Then they moved forward with scheduling the surgery.

“There are several choices for bariatric surgery, but we decided a vertical sleeve gastrectomy would work best for him and his condition. That procedure provides better options for managing fluids and anemia, which is a potential issue with a patient in renal failure,” explained Dr. Kleinpeter.

In a vertical sleeve gastrectomy, a large portion of the stomach is removed – approximately 80 percent. This limits the amount of food that can be eaten, making patients feel full sooner. The procedure also alters the hormonal production of the stomach that has some relation to appetite, so it helps control hunger as well.

Sleeve Gastrectomy

Sleeve Gastrectomy


The surgery, says Kleinpeter, is only one small part of what contributes to patient success. Post-operative care is critical, and includes individually tailored support to keep patients motivated, work through their weight loss barriers and meet their goals. Patients learn new nutritional habits, are encouraged to exercise, and learn to develop sustainable, healthy habits to keep the weight off long term.

Gomez knows how critical those changes can be. “You’ve got to change your eating habits. Whatever you were eating before the surgery, you ain’t eating after. When I go to restaurant and sit down, I’ve got to order from the kids menu or my wife and I share a plate because I can only eat two to four ounces at a time.”

Six months after his surgery, Gomez is looking – and feeling – like a new man. He has lost 70 pounds, shrinking from 305 to 235 pounds. He says he’s met his transplant goal, but is still aiming to meet his personal goal of 200.

Before

Before

After

After

Dr. Kleinpeter says continuing his weight loss will further improve Gomez’s overall long-term health. “When people hear bariatric surgery, their immediate thought is weight loss. But it also improves diabetes, blood pressure, foot pain, knee pain, joint problems. We’ll meet patients who are in similar situations – trying to lose weight for some kind of procedure, like a hip replacement or knee replacement. We get referrals from orthopedic surgeons, spine surgeons and other doctors who can’t operate until patients lose weight.”

Gomez is preparing to undergo his final round of testing to determine if he’s healthy enough for the kidney transplant. He has been on the transplant waiting list since beginning dialysis, but says he’s blessed to have a relative who has volunteered to be his kidney donor – his first cousin. She also needs to undergo further to confirm she is a match as a donor.

If all goes well, Gomez hopes to have a new kidney before the end of the year. What he says he’s looking forward to the most:

“Living a healthier life is the main thing, so I can grow old with my grandkids.”

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