Symposium on Obesity and Transplantation: Comparing Medical Nutrition Therapy, Pharmacotherapy, and Bariatric Surgery

项目总结 肥胖仍然是实体器官移植的一个重要障碍。等待肥胖的患者 肾、肝和心脏移植通常被推迟或拒绝移植，直到实现减肥。 我们建议召开一次研究发展会议，以审查和讨论证据基础和当前 围绕使用医疗营养治疗、药物治疗和减肥手术的做法来支持 患者在实体器官移植前的体重减轻情况。拟召开的肥胖与固体问题研讨会 器官移植：医学营养治疗、药物治疗和减肥手术的作用 召集一个由临床医生、研究人员和专职卫生专业人员(即社会工作者、 营养学家、营养学家)在固体器官移植和肥胖领域以及肥胖患者 等待移植以制定未来十字路口比较有效性研究的议程 并制定战略，减少收到救命和改变生命的物资的延误 移植和等待肥胖症患者的死亡名单。拟召开的研究发展会议 AHRQ资助的肥胖与肾移植研讨会于#年5月成功举办 2021年(R13HS028377)。这个首届混合活动吸引了486名注册者和317名与会者；会议 还产生了56个研究问题和压倒性的积极评价。拟议中的会议 对这一首届活动进行扩展，旨在：1)激发患者对以下方面的看法和经验 减肥与管理在肾、肝、心准备中的挑战与成功 移植；2)提供一个论坛，分享与使用 移植前解决肥胖问题的医疗营养治疗、药物治疗和减肥手术； 3)制定研究议程，包括具体的研究问题，以调查与肥胖有关的问题 和移植。我们建议组织、宣传、实施和评估研讨会，并 与我们现有的指导委员会合作，传播产生的内容。此外，还有三个 经过评估并等待肾、肝、肺或心脏移植的患者，以及 同时患有肥胖症延迟移植的患者将被招募为患者合作伙伴 指导委员会成员。另外三名患者合作伙伴将担任研讨会小组成员和 将作为移植候选人向临床医生观众分享个人减肥经验， 研究人员和相关的卫生专业人员。我们预期的结果包括一份来自 研讨会内容和讨论，以及未来比较的具体研究问题的议程 医用营养疗法、药物疗法和减肥手术治疗糖尿病的疗效研究 在实体器官移植前治疗肥胖症。

PROJECT SUMMARY Obesity continues to be a significant barrier to solid organ transplantation. Patients with obesity awaiting kidney, liver, and heart transplantation are often delayed or denied transplants until weight loss is achieved. We propose a research development conference to review and discuss the evidence-base and current practices surrounding the use of medical nutritional therapy, pharmacotherapy, and bariatric surgery to support patients' weight loss prior to solid organ transplantation. The proposed Symposium on Obesity and Solid Organ Transplantation: The Role of Medical Nutrition Therapy, Pharmacotherapy, and Bariatric Surgery, will convene a multidisciplinary group of clinicians, researchers and allied health professionals (i.e., social workers, nutritionists, dieticians) in the fields of solid organ transplantation and obesity as well as patients with obesity awaiting transplantation to develop an agenda for future comparative effectiveness research at the intersection of these fields and develop strategies for reducing delays in the receipt of life-saving and life-changing transplants and wait list mortality for patients with obesity. The proposed research development conference builds on our successful AHRQ-funded Symposium on Obesity and Kidney Transplantation held in May of 2021 (R13HS028377). This inaugural hybrid event garnered 486 registrants and 317 attendees; the meeting also generated 56 research questions and overwhelmingly positive reviews. The proposed conference expands on this inaugural event and aims to: 1) elicit patient perspectives on and experiences with regarding the challenges and successes of weight loss and management in preparation for kidney, liver and heart transplantation; 2) provide a forum for sharing research findings and clinical experience related to the use of medical nutritional therapy, pharmacotherapy, and bariatric surgery to address obesity prior to transplantation; 3) generate a research agenda, including specific research questions, to investigate issues related to obesity and transplantation. We propose to organize, advertise, implement and evaluate the symposium, and disseminate the resulting content in collaboration with our existing Steering Committee. In addition, three patients who have been evaluated and waitlisted for kidney, liver, lung, or heart transplantation and who concurrently suffer from obesity that is delaying transplantation will be recruited as patient partners to serve as members of the Steering Committee. Three additional patient partnerss will serve as symposium panelists and will share personal experience with weight loss as a transplant candidate to an audience of clinicians, researchers and allied health professionals. Our anticipated outcomes include a manuscript from the symposium content and discussions, and an agenda with specified research questions for future comparative effectiveness research on the use of medical nutritional therapy, pharmacotherapy, and bariatric surgery to treat obesity prior to solid organ transplantation.