Prevalence of Bariatric Surgery in Patients with Severe Alcoholic Hepatitis Undergoing Evaluation for Early Liver Transplantation

Roux-en-Y Gastric Bypass Is Associated With Increased Hazard for De Novo Alcohol-related Complications and Liver Disease

“…While NAFLD is not a primary indication to pursue bariatric surgery, studies have shown that bariatric surgery has been associated with decreased hepatic steatosis, inflammation, and fibrosis 23–25. What is concerning is our finding that bariatric surgery, particularly RYGB, was associated with an increased hazard of developing alcoholic hepatitis, a finding that is consistent with prior studies suggesting bariatric surgery as a risk factor for alcoholic hepatitis 26,27. This association is of heightened importance, as alcoholic hepatitis would increase the risk for the development of chronic alcohol-related liver disease and liver failure due to alcoholic hepatitis, and we have seen an increase in the burden of alcohol-related liver disease over the past 2 decades 28,29.…”

“…[23][24][25] What is concerning is our finding that bariatric surgery, particularly RYGB, was associated with an increased hazard of developing alcoholic hepatitis, a finding that is consistent with prior studies suggesting bariatric surgery as a risk factor for alcoholic hepatitis. 26,27 This association is of heightened importance, as alcoholic hepatitis would increase the risk for the development of chronic alcohol-related liver disease and liver failure due to alcoholic hepatitis, and we have seen an increase in the burden of alcohol-related liver disease over the past 2 decades. 28,29 If RYGB increases the risk for AUDs, alcoholic hepatitis, and alcohol-related cirrhosis, then patients who undergo RYGB for the management of obesity with concomitant NAFLD must be counseled regarding the importance of alcohol avoidance to prevent further liver injury and progressive chronic liver disease.…”