Obesity management in the liver transplant recipient

Bonner, Keisha; Heimbach, Julie K.

doi:10.1097/mot.0000000000000513

Cited by 17 publications

(9 citation statements)

References 43 publications

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“…If these dietary approaches are unwanted or ineffective, more aggressive techniques (such as bariatric surgery) can be considered for selected patients [ 122 ]. New approaches to weight loss using bariatric endoscopy are promising and need to be evaluated in transplant recipients [ 123 , 124 ].…”

Section: Resultsmentioning

confidence: 99%

Therapeutic Physical Exercise Programs in the Context of NASH Cirrhosis and Liver Transplantation: A Systematic Review

et al. 2023

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In recent years, various physical exercise interventions have been developed with a view to reducing comorbidity and morbidity rates among patients with chronic diseases. Regular physical exercise has been shown to reduce hypertension and mortality in patients with type 2 diabetes. Diabetes and obesity are often associated with the development of nonalcoholic fatty liver disease, which can lead to liver fibrosis and then (in some cases) nonalcoholic steatohepatitis cirrhosis. We searched the literature for publications on personalized physical exercise programs in cirrhotic patients before and after liver transplantation. Eleven studies in cirrhotic patients and one study in liver transplant recipients were included in the systematic review, the results of which were reported in compliance with the preferred reporting items for systematic reviews and meta-analyses guidelines. The personalized physical exercise programs lasted for 6 to 16 weeks. Our review evidenced improvements in peak oxygen consumption and six-minute walk test performance and a reduction in the hepatic venous pressure gradient. In cirrhotic patients, personalized physical exercise programs improve quality of life, are not associated with adverse effects, and (for transplant recipients) might reduce the 90-day hospital readmission rate. However, none of the literature data evidenced reductions in the mortality rates before and after transplantation. Further prospective studies are needed to evaluate the benefit of long-term physical exercise programs in cirrhotic patients before and after liver transplantation.

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Section: Resultsmentioning

confidence: 99%

Therapeutic Physical Exercise Programs in the Context of NASH Cirrhosis and Liver Transplantation: A Systematic Review

et al. 2023

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“…95,96 Bariatric surgery in transplant patients has been comprehensively reviewed elsewhere. 97,98 Good outcomes have been reported with sleeve gastrectomy pre-and post-liver transplant, [99][100][101][102][103][104][105][106] as well as pre-and post-kidney transplant. 100,102,103 Combined liver transplant and sleeve gastrectomy also demonstrated improvement in weight and metabolic factors posttransplant.…”

Section: Nafld In Kidney Disease Patients and Morbid Obesitymentioning

confidence: 99%

Current and Evolving Indications for Simultaneous Liver Kidney Transplantation

Levitsky

2021

Semin Liver Dis

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This review will discuss the etiologies of kidney disease in liver transplant candidates, provide a historical background of the prior evolution of simultaneous liver–kidney (SLK) transplant indications, discuss the current indications for SLK including Organ Procurement and Transplantation Network policies and Model for End Stage Liver Disease exception points, as well as provide an overview of the safety net kidney transplant policy. Finally, the authors explore unanswered questions and future research needed in SLK transplantation.

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“…In the setting of LT, the association with obesity has become more frequent, since obesity-related liver disease such as NAFLD/NASH is now one of three most common indications for listing for LT [120]. While some studies did not identify obesity as a predictor of poor prognosis, even when BMI was adjusted for ascites [15,121,122], others associated obesity with significantly lower post-LT survival, suggesting lower post-transplantation survival for obese LT recipient in comparing to a lean [123][124][125].…”

Section: Sleeve and Organ Transplantationmentioning

confidence: 99%

“…Despite higher morbimortality, BS appeared to be feasible and safe [129]. Likewise, a comprehensive review of the management of obesity in the LT settings has concluded that the optimal timing of bariatric surgery depends in part on the clinical condition of each patient [120]. Lastly, recent comprehensive review addressing the role of BS in the setting of organ transplantation has concluded that BS should be applied only after LT, and the SG is strongly recommended due to lower mortality, improvement on graft function, and preservation of easier endoscopic access to the biliary tree [112].…”

Section: Sleeve and Organ Transplantationmentioning

confidence: 99%

Special Indications: Cirrhosis, Inflammatory Bowel Disease, and Organ Transplantation

Bastos

Cardoso

2020

The Perfect Sleeve Gastrectomy

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LSG is a faster, simpler procedure that does not lead to any change in the original anatomy of the small bowel, technically addressing only the stomach. While the maintenance of the intestinal absorption surface may raise concerns about an unfavorable factor for satisfactory weight loss and favorable for weight recovery in the long-term postoperative, the LSG technical features may be quite advantageous in patients with some non-obesity-related diseases, where a procedure with shorter operative time without affecting the small bowel anatomy may be quite advisable. Cirrhosis, inflammatory bowel diseases, and pre-and post-solid organ transplantation are some of these issues addressed in this chapter on special indications of LSG. Sleeve and CirrhosisSteatosis, inflammation, and fibrosis are stages of pathological liver damage very commonly associated with obesity and present in about 80-90% of morbidly obese patients undergoing bariatric surgery (BS) [1,2]. Nonalcoholic fatty liver disease

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Obesity management in the liver transplant recipient

Abstract: Obesity-related liver disease has become one of the most common indications for liver transplantation and further research is needed to determine the role of bariatric surgery in the optimal management of this population.

Cited by 17 publications

References 43 publications

Therapeutic Physical Exercise Programs in the Context of NASH Cirrhosis and Liver Transplantation: A Systematic Review

Therapeutic Physical Exercise Programs in the Context of NASH Cirrhosis and Liver Transplantation: A Systematic Review

Current and Evolving Indications for Simultaneous Liver Kidney Transplantation

Special Indications: Cirrhosis, Inflammatory Bowel Disease, and Organ Transplantation

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