Outcome of liver transplantation in patients with prior bariatric surgery
Liver Transpl 2017; 23(11):1415-1421.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Nonalcoholic fatty liver disease is becoming the leading cause of disease resulting in liver transplantation (LT). As a result of this trend, more LT candidates are presenting with prior history of bariatric surgery (BS). Over the last decade, 960 patients underwent LT at our institution; 11 (1.1%) had prior BS. The most common type of BS was Roux-en-Y gastric bypass (n = 9) with 1 sleeve gastrectomy and 1 jejunoileal bypass. A total of 9 patients underwent LT alone, and 2 underwent simultaneous liver-kidney transplantation. The most common indication for LT was nonalcoholic steatohepatitis (n = 10) with 5 having additional diagnosis of alcoholic liver disease. The 30-day reoperation rate was 36.4% (n = 4); indications were bile duct repair (n = 3) and wound repair (n = 1). In the first 6 months after LT, biliary complications were seen in 54.5% (n = 6) of the patients. Both patient and graft survival rates at 1 and 2 years were 81.8% (n = 9) and 72.7% (n = 8), respectively. A total of 8 patients (72.7%) had indications for liver biopsy after LT; significant macrovesicular steatosis was found in 2 (18.2%). In patients with a history of alcohol consumption, 2 (40.0%) relapsed after LT. Two patients (18.2%) had a history of diet-controlled diabetes before LT; 1 of these patients became insulin dependent after LT. Mean body mass index (BMI) at LT was 31.0 ± 5.7 kg/m
Medical Subject Headings
Adult; Allografts; Bile Ducts; Body Mass Index; End Stage Liver Disease; Female; Follow-Up Studies; Gastrectomy; Gastric Bypass; Graft Survival; Humans; Liver; Liver Transplantation; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Obesity, Morbid; Postoperative Complications; Recurrence; Reoperation; Retrospective Studies; Treatment Outcome