Bariatric surgery, obesity and liver transplantation

Ahmed, Zunirah; Khan, Muhammad Ali; Vazquez‐Montesino, Luis Miguel; Ahmed, Aijaz

doi:10.21037/tgh-2020-14

Cited by 8 publications

(4 citation statements)

References 81 publications

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“…In 2001, the first case report presented two patients that underwent Roux‐en‐Y gastric bypass due to recurrent NASH after LT 50 . Multiple case reports followed including different bariatric techniques for patients with obesity and NASH at different times, that is before, during or after LT 51–55 . In our survey, most of the respondents prefer to perform the MBS ‘before’ LT, an answer mainly selected by bariatric surgeons.…”

Section: Discussionmentioning

confidence: 94%

“…While the integration of MBS as essential part of a holistic treatment plan for NASH candidates with cirrhosis and obesity is the logic consequence, one key question remains with the best possible timing of MBS (Figure 5). In 2001, the first case report presented two patients that underwent Roux-en-Y gastric bypass due to recurrent NASH after LT. 50 Multiple case reports followed including different bariatric techniques for patients with obesity and NASH at different times, that is before, during or after LT. [51][52][53][54][55] In our survey, most of the respondents prefer to perform the MBS 'before' LT, an answer mainly selected by bariatric surgeons. Simultaneous procedures combining LT and MBS were preferred by transplant surgeons instead.…”

Section: Transplant Surgeonsmentioning

confidence: 94%

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How best to combine liver transplantation and bariatric surgery?—Results from a global, web‐based survey

Widmer,

Eden,

Abbassi

et al. 2023

Liver International

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Background and AimsObesity is a growing healthcare challenge worldwide and a significant risk factor for liver failure as seen with non‐alcoholic steatohepatitis (NASH). Combining metabolic‐bariatric surgery (MBS) with liver transplantation (LT) appears as attractive strategy to treat both, the underlying liver disease and obesity. However, there is an ongoing debate on best timing and patient selection. This survey was designed to explore the current treatment practice for patients with NASH and obesity worldwide.MethodsA web‐based survey was conducted in 2022 among bariatric and LT surgeons, and hepatologists from Europe, North and South America and Asia.ResultsThe survey completion rate was 74% (145/196). The average respondents were 41–50 years (38%), male (82.1%) and had >20 years of clinical experience (42.1%). Centres with a high LT‐caseload for NASH were mainly located in the USA and United Kingdom. Almost 30% have already performed a combination of LT with MBS and 49% plan to do it. A majority of bariatric surgeons prefer MBS before LT (77.2%), whereas most of LT surgeons (52%) would perform MBS during LT. Most respondents (n = 114; 80%) favour sleeve gastrectomy over other bariatric techniques. One third (n = 42; 29.4%) has an established protocol regarding MBS for LT candidates.ConclusionThe most experienced centres doing LT for NASH are in the USA and United Kingdom with growing awareness worldwide. Overall, a combination of MBS and LT has already been performed by a third of respondents. Sleeve gastrectomy is the bariatric technique of choice—preferably performed either before or during LT.

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Section: Discussionmentioning

confidence: 94%

Section: Transplant Surgeonsmentioning

confidence: 94%

How best to combine liver transplantation and bariatric surgery?—Results from a global, web‐based survey

Widmer,

Eden,

Abbassi

et al. 2023

Liver International

View full text Add to dashboard Cite

show abstract

“…[5,6] Despite the growing use of these interventions in the pretransplant population, literature is limited with regard to the impact of pharmacological and surgical interventions on weight loss in the posttransplant setting. [7,8] In this issue of Liver Transplantation, Richardson et al [9] present a study on the use of glucagon-like peptide 1 receptor agonists (GLP-1RAs) in liver transplant recipients (LTRs), and Chow et al [10] reported the effectiveness of semaglutide in achieving weight loss in LTRs. Richardson and colleagues performed a retrospective single-center study to determine the impact of GLP-1RAs on total body weight loss (TBWL) over a 1-year time period in LTRs seen in a weight-loss clinic.…”

mentioning

confidence: 99%

“…Currently, there are several treatment options for patients with obesity and MASH/MASLD ranging from pharmacotherapy to endoscopic bariatric metabolic therapies as well as bariatric surgery 5,6 . Despite the growing use of these interventions in the pretransplant population, literature is limited with regard to the impact of pharmacological and surgical interventions on weight loss in the posttransplant setting 7,8 …”

mentioning

confidence: 99%