Obesity in the Liver Transplant Setting.
Study Goal
The researchers aimed to evaluate the role of bariatric surgery, particularly sleeve gastrectomy, in managing obesity in liver transplant candidates and its impact on safety and efficacy.
Results Summary
The study suggests that sleeve gastrectomy offers a good balance between safety and efficacy in liver transplant patients, though long-term outcomes remain controversial and scarce. Morbid obesity may adversely affect patient and graft survival, especially in NAFLD cases.
Population
Liver transplant candidates with obesity, particularly those with non-alcoholic fatty liver disease (NAFLD).
Effective Dosage
Not Assessed
Duration
Not Assessed
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
diet and exercise | decrease | obesity | obese patients | - | should be the backbone of obesity treatment | #1 |
bariatric surgery | decrease | obesity | obese patients | - | is an alternative for treatment | #2 |
sleeve gastrectomy | increase | obesity treatment outcomes | liver transplant patients | - | offers a good balance between safety and efficacy | #3 |
The obesity epidemic has resulted in an increased prevalence of obesity in liver transplant (LT) candidates and in non-alcoholic fatty liver disease (NAFLD) becoming the fastest growing indication for LT. LT teams will be dealing with obesity in the coming years, and it is necessary for them to recognize some key aspects surrounding the LT in obese patients. Obesity by itself should not be considered a contraindication for LT, but it should make LT teams pay special attention to cardiovascular risk assessment, in order to properly select candidates for LT. Obese patients may be at increased risk of perioperative respiratory and infectious complications, and it is necessary to establish preventive strategies. Data on patient and graft survival after LT are controversial and scarce, especially for long-term outcomes, but morbid obesity may adversely affect these outcomes, particularly in NAFLD. The backbone of obesity treatment should be diet and exercise, whilst being careful not to precipitate or worsen frailty and sarcopenia. Bariatric surgery is an alternative for treatment of obesity, and the ideal timing regarding LT is still unknown. Sleeve gastrectomy is probably the procedure that has the best evidence in LT because it offers a good balance between safety and efficacy.