Intragastric balloon as a novel modality for weight loss in patients with cirrhosis and morbid obesity awaiting liver transplantation

Choudhary, Narendra S.; Puri, Rajesh; Saraf, Neeraj; Saigal, Sanjiv; Kumar, Naveen; Rai, Rahul; Rastogi, Amit; Goja, Sanjay; Bhangui, Prashant; Ramchandra, Sumana K.; Raut, Vikram; Sud, Randhir; Soin, Arvinder S.

doi:10.1007/s12664-016-0643-2

Cited by 45 publications

(27 citation statements)

References 17 publications

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“…Small studies reporting outcomes in patients with decompensated cirrhosis and CSPH [68] show an acceptable safety profile. However, the presence of gastric varices, large esophageal varices, or severe portal hypertensive gastropathy, all of which are commonly found in the decompensated patient, are contraindications for this procedure [69,70].…”

Section: Obesity Before Liver Transplantationmentioning

confidence: 99%

Obesity in the Liver Transplant Setting

2019

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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.

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Section: Obesity Before Liver Transplantationmentioning

confidence: 99%

Obesity in the Liver Transplant Setting

2019

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“…21,22 Recently, there has been growing interest in the possibility of endoluminal treatments for obesity in individuals with high surgical risk. An endoscopic intragastric balloon implant in this group of patients, which is an attractive alternative, has presented satisfactory results in studies conducted by Choudhary et al 25 A case report by Campsen et al 26 showed the realization of adjustable gastric band implantation during a liver transplant had satisfactory results after 6 months. Heimbach et al 27 reported the combined realization of liver transplantation and vertical sleeve gastrectomy in seven patients with one case of a fistula on the staple line and zero mortality.…”

Section: Resultsmentioning

confidence: 93%

Bariatric surgery in individuals with liver cirrhosis: A narrative review

Cazzo

Gestic

Chaim

et al. 2017

Rev. Assoc. Med. Bras.

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Summary Introduction: Bariatric surgery has become the gold standard treatment for morbid obesity, but there is no consensus regarding its safety and efficacy among individuals with chronic liver diseases. Objective: To critically evaluate the existing evidence on literature about bariatric surgery in individuals with liver cirrhosis. Method: Narrative review performed by means of an online search in the MEDLINE and LILACS databases. Results: Bariatric surgery is safe and effective in individuals with chronic liver disease without clinical decompensation or significant portal hypertension. Individuals with severe liver function impairment present significantly higher surgical morbidity and mortality. Among candidates to liver transplantation, surgery may be performed before, after and even during transplantation, and there is a predominant trend to perform it after. Vertical sleeve gastrectomy seems to be the most adequate technique in this group of subjects. Conclusion: Bariatric surgery is safe and effective in individuals with compensated cirrhosis without significant portal hypertension, but presents higher morbidity. Among candidates to liver transplantation and/or individuals with severe portal hypertension, morbidity and mortality are significantly higher.

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“…This approach may also help select candidates who have a higher likelihood of success owing to inherent motivation and compliance required to undergo a procedure [15,16]. Not only a bridge to bariatric surgery, but endobariatric therapies may also have a role in bridging to organ transplantation, allowing pretransplant candidates to meet transplant eligibility and decrease posttransplant morbidity and mortality, as demonstrated in previous studies of heart and liver transplants [17,18]. Endobariatric therapies are already proven metabolic therapies with a potential utility in patients with primary diabetes or nonalcoholic fatty liver disease [19,20].…”

Section: The Role Of Endobariatric Therapies and Appropriate Candidatesmentioning

confidence: 99%

Endoscopic Treatment for Obesity and Weight Management: State of the Art

Jaruvongvanich¹,

Storm²,

Dayyeh³

2020

Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

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Obesity is a rising pandemic associated with numerous comorbidities and increased mortality. Although effective and durable, bariatric surgery is performed in less than 1% of eligible candidates. It has been underutilized due to its invasiveness, costs, and risk profile. At the other end of the obesity treatment spectrum, lifestyle intervention frequently fails to achieve effective and durable weight loss. Endoscopic bariatric therapies have emerged to bridge this treatment

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Intragastric balloon as a novel modality for weight loss in patients with cirrhosis and morbid obesity awaiting liver transplantation

Abstract: Intragastric balloon placement is a useful modality for promoting short-term weight loss and thereby making morbidly obese recipients fit for liver transplantation surgery.

Cited by 45 publications

References 17 publications

Obesity in the Liver Transplant Setting

Obesity in the Liver Transplant Setting

Bariatric surgery in individuals with liver cirrhosis: A narrative review

Endoscopic Treatment for Obesity and Weight Management: State of the Art

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