Weight gain after orthotopic liver transplantation: Is nonalcoholic fatty liver disease cirrhosis a risk factor for greater weight gain?

Kouz, Jasmine; Vincent, Catherine; Leong, Aaron; Dorais, Marc; Räkel, Agnès

doi:10.1002/lt.23951

Cited by 22 publications

(14 citation statements)

References 35 publications

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“…As we reported, transplant patients often develop IR and an increase in body weight [ 1 ]. Interestingly, Kouz et al [ 55 ] demonstrated that in patients transplanted for NASH-cirrhosis, most of the weight gain occurs in the first year after LT, while the increase of the weight is more progressive in subjects with a different etiology. However, regardless of the kind of pre-LT liver disease, after LT a relevant increase in dietary intake can be found, especially in patients with pre-LT severe dietary restrictions, gastrointestinal symptoms or anorexia.…”

Section: Therapeutic Approach Against Post-transplant Dysmetabolismentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome after Liver Transplant

Gitto

Villa

2016

IJMS

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Liver transplant is the unique curative therapy for patients with acute liver failure or end-stage liver disease, with or without hepatocellular carcinoma. Increase of body weight, onset of insulin resistance and drug-induced alterations of metabolism are reported in liver transplant recipients. In this context, post-transplant diabetes mellitus, hyperlipidemia, and arterial hypertension can be often diagnosed. Multifactorial illnesses occurring in the post-transplant period represent significant causes of morbidity and mortality. This is especially true for metabolic syndrome. Non-alcoholic steatosis and steatohepatitis are hepatic manifestations of metabolic syndrome and after liver transplant both recurrent and de novo steatosis can be found. Usually, post-transplant steatosis shows an indolent outcome with few cases of fibrosis progression. However, in the post-transplant setting, both metabolic syndrome and steatosis might play a key role in the stratification of morbidity and mortality risk, being commonly associated with cardiovascular disease. The single components of metabolic syndrome can be treated with targeted drugs while lifestyle intervention is the only reasonable therapeutic approach for transplant patients with non-alcoholic steatosis or steatohepatitis.

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Section: Therapeutic Approach Against Post-transplant Dysmetabolismentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome after Liver Transplant

Gitto

Villa

2016

IJMS

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“…Rapid weight gain after liver transplant is a worldwide phenomenon with 16-46% of liver transplant recipients (LTRs) becoming obese in the first year after transplant. [1][2][3][4][5][6][7][8] There is a higher prevalence of metabolic syndrome in LTRs compared with the general adult population and this appears to predispose to increasing cardiovascular disease risk, graft rejection, infection and other complications. 9 Adjusting to a liver transplant is a complex process which incorporates both physical and mental components of recovery.…”

Section: Introductionmentioning

confidence: 99%

‘Back to Life’—Using knowledge exchange processes to enhance lifestyle interventions for liver transplant recipients: A qualitative study

Hickman

Coran

Wallen

et al. 2019

Nutrition & Dietetics

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Aim Interventions to prevent excessive weight gain after liver transplant are needed. The purpose of the present study was to enhance a specialist post‐transplant well‐being program through knowledge exchange with end‐users. Methods The study used an interactive process of knowledge exchange between researchers, clinicians and health system users. Data were collected as focus groups or telephone interviews and underwent applied thematic analysis. Results There were 28 participants (age 24–68 years; 64% male). The results identified experiences that may influence decisions around health behaviours during the course of transplant recovery. Three over‐arching themes were identified that impact on liver transplant recipients post‐transplant health behaviours. These include (i) Finding a coping mechanism which highlighted the need to acknowledge the significant emotional burden of transplant prior to addressing long‐term physical wellness; (ii) Back to Life encompassing the desire to return to employment and prioritise family, while co‐ordinating the burden of ongoing medical monitoring and self‐management and (iii) Tailored, Personalised Care with a preference for health care delivery by transplant specialists via a range of flexible eHealth modalities. Conclusions This person‐centred process of knowledge exchange incorporated experiences of recipients into service design and identified life priorities most likely to influence health behaviours post‐transplant. Patient co‐creation of services has the potential to improve the integration of knowledge into health systems and future directions will require evaluation of effectiveness and sustainability of patient‐centred multidisciplinary service development.

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“…To our knowledge, this is the first study to address this aspect in a group of patients well known to acquire weight after the operation . Approximately one‐third to two‐thirds of the patients are obese soon after LTx. Of the 270 patients evaluated in the present study, 64.1% were classified as having excessive weight and 23.3% were classified as obese.…”

Section: Discussionmentioning

confidence: 94%

Eating behaviour patterns are associated with excessive weight gain after liver transplantation

Ferreira

Penaforte

Cardoso

et al. 2019

J Human Nutrition Diet

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Background: Weight gain and obesity are important issues in liver transplant (LTx) recipients. Although dietary habits are probably related to excessive weight gain after LTx, some studies have failed to demonstrate these associations. The present study aimed to assess eating behaviour and verify its association with weight gain and excessive weight among LTx recipients. Methods: The investigation comprised a cross-sectional study. Post-LTx patients, aged >18 years were evaluated about their eating behaviour [Three Factor Eating Questionnaire-R21 (TFEQ-R21)]. The scores of the TFEQ-R21 [uncontrolled eating (UE), cognitive restraint (CR) and emotional eating (EE)] were determined. Excessive weight was classified as body mass index ≥25 kg/m² and obesity ≥30 kg/m². Results: In total, 270 patients (age 58.0 years; range 20.0-77.0 years; 64.1% men) were assessed. Average weight gain was 8.0 kg (range À16.0 to 41.0 kg). Of the patients, 64.1% (n = 173) had excessive weight and 23.3% (n = 63) were obese. Post-LTx weight gain was significantly correlated with UE (r = 0.311, P < 0.001) and EE (r = 0.287, P < 0.001). Patients with excessive weight had significantly higher scores than others: CR (61.0; range 0-122.0 versus 44.0; range 0-116.0) (P = 0.003) and EE (11.0; range 0-100.0 versus 0.0; range 0-100.0) (P = 0.030). Patients with obesity had higher scores than non-obese UE (22.0; range 0-77.0 versus 14.0; range 0-85.0; P = 0.028), CR (55.0; range 11.0-116.0 versus 50.0; range 0-122.0) (P = 0.017) and EE (16.0; range 0-100.0 versus 5.0; range 0-100.0) individuals (P < 0.001). The greatest quartiles of weight gain had higher scores on the eating behaviours of UE and EE, especially those with weight gain ≥14 kg. UE was associated with weight gain. CR was associated with being overweight. EE was associated with obesity. Conclusions: Uncontrolled eating is associated with weight gain, CR was associated with excessive weight and EE was associated with obesity after LTx. 693

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Weight gain after orthotopic liver transplantation: Is nonalcoholic fatty liver disease cirrhosis a risk factor for greater weight gain?

Cited by 22 publications

References 35 publications

Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome after Liver Transplant

Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome after Liver Transplant

‘Back to Life’—Using knowledge exchange processes to enhance lifestyle interventions for liver transplant recipients: A qualitative study

Eating behaviour patterns are associated with excessive weight gain after liver transplantation

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