Subhashini Ayloo1, Chester Guss2, Sri Ram Pentakota2, Joyce Hanna2, Michele Molinari3. 1. Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey. Electronic address: Ayloo.sub@rutgers.edu. 2. Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey. 3. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: Obesity is a major public health burden that affects the transplant community because of its key role in fatty liver disease and transplantation outcomes. OBJECTIVES: To evaluate the role of sleeve gastrectomy in treating recurrent and de novo nonalcoholic fatty liver disease (NAFLD) in liver transplant recipients. SETTING: A university hospital. METHODS: We describe 2 obese liver transplant recipients with recurrent and de novo NAFLD who underwent minimally invasive metabolic and bariatric surgery. RESULTS: The surgery was performed successfully, with much of the operative time consumed by enterolysis. There were no intraoperative or postoperative complications. At last follow-up appointment (16 months postoperatively), there was a mean reduction in weight (31.98 kg), body mass index (10.2 kg/m2), glycosylated hemoglobin (1.05%), alanine aminotransferase (38 IU/L), steatosis score (0.34), and fibrosis score (0.05). The mean decrease in 6-month postoperative hepatic fat quantification was 6%. CONCLUSIONS: These cases show that metabolic and bariatric surgery in obese, posttransplant recipients with recurrent and de novo nonalcoholic steatohepatitis lead to improved steatosis and reduced obesity and obesity-associated comorbidities.
BACKGROUND:Obesity is a major public health burden that affects the transplant community because of its key role in fatty liver disease and transplantation outcomes. OBJECTIVES: To evaluate the role of sleeve gastrectomy in treating recurrent and de novo nonalcoholic fatty liver disease (NAFLD) in liver transplant recipients. SETTING: A university hospital. METHODS: We describe 2 obese liver transplant recipients with recurrent and de novo NAFLD who underwent minimally invasive metabolic and bariatric surgery. RESULTS: The surgery was performed successfully, with much of the operative time consumed by enterolysis. There were no intraoperative or postoperative complications. At last follow-up appointment (16 months postoperatively), there was a mean reduction in weight (31.98 kg), body mass index (10.2 kg/m2), glycosylated hemoglobin (1.05%), alanine aminotransferase (38 IU/L), steatosis score (0.34), and fibrosis score (0.05). The mean decrease in 6-month postoperative hepatic fat quantification was 6%. CONCLUSIONS: These cases show that metabolic and bariatric surgery in obese, posttransplant recipients with recurrent and de novo nonalcoholic steatohepatitis lead to improved steatosis and reduced obesity and obesity-associated comorbidities.
Authors: Víctor Lopez-Lopez; Juan José Ruiz-Manzanera; Dilmurodjon Eshmuminov; Kuno Lehmann; Marcel Schneider; Markus von der Groeben; David Ruiz de Angulo; Ursula Gajownik; Jose Antonio Pons; Francisco Sánchez-Bueno; Ricardo Robles-Campos; Pablo Ramírez-Romero Journal: Obes Surg Date: 2020-11-23 Impact factor: 4.129
Authors: John R Montgomery; Jordan A Cohen; Craig S Brown; Kyle H Sheetz; Grace F Chao; Seth A Waits; Dana A Telem Journal: Am J Transplant Date: 2020-05-08 Impact factor: 8.086