The Impact of Bariatric-Surgery-Induced Weight Loss on Patients Undergoing Liver Transplant: A Focus on Metabolism, Pathophysiological Changes, and Outcome in Obese Patients Suffering NAFLD-Related Cirrhosis

Sarno, Gerardo; Schiavo, Luigi; Calabrese, P; Córdova, Ludwig Roberto Álvarez; Frías-Toral, Evelyn; Cucalón, Gabriela; Garcia-Velasquez, Eloisa; Fuchs-Tarlovsky, Vanessa; Pilone, Vincenzo

doi:10.3390/jcm11185293

Cited by 4 publications

(3 citation statements)

References 76 publications

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“…Immunosuppressive therapy after allograft solid organ transplantation is required to prevent rejection and preserve organ function (40)(41)(42)(43). Various combinations of currently approved agents are needed to obtain the patients' tailored regimens to balance adequate immunosuppression with drugs' side effects (44)(45)(46)(47) through continuous titration to reduce their side effects due to their narrow therapeutic index (48)(49)(50)(51). In this light, a reliable drug supply chain is even more urgent due to the risk of counterfeit medications.…”

Section: Drugsmentioning

confidence: 99%

Implementation of Blockchain Technology Could Increase Equity and Transparency in Organ Transplantation: A Narrative Review of an Emergent Tool

Anselmo¹,

Materazzo²,

Lorenzo³

et al. 2023

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In the last few years, innovative technology and health care digitalization played a major role in all medical fields and a great effort worldwide to manage this large amount of data, in terms of security and digital privacy has been made by different national health systems. Blockchain technology, a peer-to-peer distributed database without centralized authority, initially applied to Bitcoin protocol, soon gained popularity, thanks to its distributed immutable nature in several non-medical fields. Therefore, the aim of the present review (PROSPERO N° CRD42022316661) is to establish a putative future role of blockchain and distribution ledger technology (DLT) in the organ transplantation field and its role to overcome inequalities. Preoperative assessment of the deceased donor, supranational crossover programs with the international waitlist databases, and reduction of black-market donations and counterfeit drugs are some of the possible applications of DLT, thanks to its distributed, efficient, secure, trackable, and immutable nature to reduce inequalities and discrimination.

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Section: Drugsmentioning

confidence: 99%

Implementation of Blockchain Technology Could Increase Equity and Transparency in Organ Transplantation: A Narrative Review of an Emergent Tool

Anselmo¹,

Materazzo²,

Lorenzo³

et al. 2023

Transpl Int

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“…Nonetheless, weight reduction occasionally comes at the expense of malnourishment and the difficulties that accompany it 10 . Furthermore, its impact on liver function, particularly potential effects on non-alcoholic fatty liver disease (NAFLD), has not yet been extensively examined 11 . Up to 90% of these individuals have NAFLD, which is very common and varies from moderate fatty liver alterations and steatosis to non-alcoholic steatohepatitis (NASH), with the potential to proceed to liver fibrosis with persistent disease 12 .…”

Section: Introductionmentioning

confidence: 99%

Diverted Mini Gastric Bypass Surgery in Obese Population: Out-turn Over Hepatic and Nephrological Parameters

Singh,

Ahmad,

Sinha

et al. 2023

Bangladesh J Med Sci

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Introduction: Bariatric surgery is the best possible option for reducing weight when lifestyle changes and medication have not brought about lasting success and may reduce morbidity and mortality. Weight loss that may follow bariatric surgery in patients on calory restricted diet would result in reduced inflammation and therefore lowering inflammation-related organ damage, including that of the kidney and liver. The study aimed to observe the consequences of BMI change on Hepatic and Nephrological parameters in patients after One Anastomosis Gastric Bypass surgery. Method: This study was done at a bariatric center with 150 individuals (both male and female) aged 20 to 60 years with obesity grades II and III who were selected randomly. Hepatic and renal function tests were carried out at baseline visit, then 3 months and 6 months following surgically. Result: Bilirubin level significantly increased from baseline to visit 1; Serum glutamic-pyruvic transaminase (SGPT) levels significantly decreased at visits 1 and 2. The albumin to Globulin ratio was significantly increased at visit 2 . Blood Urea level and serum creatinine level reduced considerably at visit 1 and decreased more at visit 2 from baseline. Conclusion: Bariatric surgery may be related to improvement in both hepatic and renal function. The improvement may be attributed to reduced inflammatory organ damage related to obesity. More such studies must be performed to highlight the possible health benefits of bariatric surgery for obese patients whose lifestyle modification and medication have not aided in weight loss. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 743-758

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“…With the aim to obtain moderate weight loss and liver volume and steatosis reduction before BS, several dietary protocols have been introduced over time, among them very low-calorie diets (VLCDs) and very low-calorie ketogenic diets (VLCKDs) are widely prescribed [ 8 , 9 , 10 , 11 , 12 ]. In particular Schiavo et al, have shown that a 4-week preoperative ketogenic diet is safe and effective at reducing body weight (−10.3%, p < 0.001, in males; −8.2%, p < 0.001, in females) and the left hepatic lobe volume (−19.8%, p < 0.001) in patients with obesity scheduled for BS [ 13 ]. Furthermore, Albanese et al, aiming to compare surgical outcome and weight loss in two groups of patients who were offered two different pre-operative kinds of diet (VLCD and VLCKD), reported that VLCKDs showed better results than VLCDs on surgical outcome, influencing the drainage output, post-operative hemoglobin levels, and hospital stay [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of Enteral Protein Nutritional Therapy on Patients with Obesity Scheduled for Bariatric Surgery: A Focus on Safety, Efficacy, and Pathophysiological Changes

et al. 2023

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Background: Ketogenic diet-induced weight loss before bariatric surgery (BS) has beneficial effects on the reduction in the liver volume, metabolic profile, and intra- and post-operative complications. However, these beneficial effects can be limited by poor dietary adherence. A potential solution in patients showing a poor adherence in following the prescribed diet could be represented by enteral nutrition strategies. To date, no studies describe the protocol to use for the efficacy and the safety of pre-operative enteral ketogenic nutrition-based dietary protocols in terms of weight reduction, metabolic efficacy, and safety in patients with obesity scheduled for BS. Aims and scope: To assess the clinical impact, efficacy, and safety of ketogenic nutrition enteral protein (NEP) vs. nutritional enteral hypocaloric (NEI) protocols on patients with obesity candidate to BS. Patients and methods: 31 NEP were compared to 29 NEI patients through a 1:1 randomization. The body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), and neck circumference (NC) were assessed at the baseline and at the 4-week follow-up. Furthermore, clinical parameters were assessed by blood tests, and patients were asked daily to report any side effects, using a self-administered questionnaire. Results: Compared to the baseline, the BW, BMI, WC, HC, and NC were significantly reduced in both groups studied (p < 0.001). However, we did not find any significative difference between the NEP and NEI groups in terms of weight loss (p = 0.559), BMI (p= 0.383), WC (p = 0.779), and HC (p = 0.559), while a statistically significant difference was found in terms of the NC (NEP, −7.1% vs. NEI, −4%, p = 0.011). Furthermore, we found a significant amelioration of the general clinical status in both groups. However, a statistically significant difference was found in terms of glycemia (NEP, −16% vs. NEI, −8.5%, p < 0.001), insulin (NEP, −49.6% vs. NEI, −17.8%, p < 0.0028), HOMA index (NEP, −57.7% vs. NEI, −24.9%, p < 0.001), total cholesterol (NEP, −24.3% vs. NEI, −2.8%, p < 0.001), low-density lipoprotein (NEP, −30.9% vs. NEI, 1.96%, p < 0.001), apolipoprotein A1 (NEP, −24.2% vs. NEI, −7%, p < 0.001), and apolipoprotein B (NEP, −23.1% vs. NEI, −2.3%, p < 0.001), whereas we did not find any significative difference between the NEP and NEI groups in terms of aortomesenteric fat thickness (p = 0.332), triglyceride levels (p = 0.534), degree of steatosis (p = 0.616), and left hepatic lobe volume (p = 0.264). Furthermore, the NEP and NEI treatments were well tolerated, and no major side effects were registered. Conclusions: Enteral feeding is an effective and safe treatment before BS, with NEP leading to better clinical results than NEI on the glycemic and lipid profiles. Further and larger randomized clinical trials are needed to confirm these preliminary data.

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The Impact of Bariatric-Surgery-Induced Weight Loss on Patients Undergoing Liver Transplant: A Focus on Metabolism, Pathophysiological Changes, and Outcome in Obese Patients Suffering NAFLD-Related Cirrhosis

Cited by 4 publications

References 76 publications

Implementation of Blockchain Technology Could Increase Equity and Transparency in Organ Transplantation: A Narrative Review of an Emergent Tool

Implementation of Blockchain Technology Could Increase Equity and Transparency in Organ Transplantation: A Narrative Review of an Emergent Tool

Diverted Mini Gastric Bypass Surgery in Obese Population: Out-turn Over Hepatic and Nephrological Parameters

Clinical Impact of Enteral Protein Nutritional Therapy on Patients with Obesity Scheduled for Bariatric Surgery: A Focus on Safety, Efficacy, and Pathophysiological Changes

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