Endoscopic Sleeve Gastroplasty After Solid Organ Transplantation: First Reported Case Worldwide in a Kidney Transplant Recipient.

Obesity adversely affects graft and cardiovascular outcomes in kidney transplant recipients, with limited effective therapies. Endoscopic sleeve gastroplasty (ESG) is established for obesity but not well studied post-transplant. We report ESG in a 33-year-old kidney transplant recipient with class III obesity. A structured search (PubMed, Embase, Scopus; January 2025) found no prior cases. ESG was completed without complications. At 6 months, meaningful weight loss and metabolic improvement occurred, with stable graft function. Semen parameters improved, without proven causality. ESG appears feasible and well tolerated in a selected patient. Safety cannot be established. Larger studies are needed.