Sleeve gastrectomy prior to liver transplantation is superior to medical weight loss in reducing posttransplant metabolic complications

Strategies to optimize the management of obesity‐related metabolic complications after liver transplantation (LT) are needed. We examined the effect of pre‐LT sleeve gastrectomy (SG), as compared to medical weight loss (MWL), on post‐LT outcomes. This is a cohort study of adults (≥18 years) with med...

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Bibliographic Details
Published in:American journal of transplantation 2021-10, Vol.21 (10), p.3324-3332
Main Authors: Sharpton, Suzanne R., Terrault, Norah A., Tavakol, Mehdi M., Posselt, Andrew M.
Format: Article
Language:English
Subjects:
Adult
Body weight
Body weight loss
clinical research / practice
Cohort Studies
comorbidities
Comorbidity
Diabetes
Diabetes mellitus
diabetes: new onset / posttransplant
Fatty liver
Gastrectomy
Gastrectomy - adverse effects
Gastrointestinal surgery
Humans
Hypertension
hypertension / antihypertensives
liver disease: metabolic
Liver diseases
Liver transplantation
Liver Transplantation - adverse effects
liver transplantation / hepatology
Liver transplants
Metabolism
Obesity
Obesity, Morbid - surgery
Regression analysis
Retrospective Studies
Treatment Outcome
Weight control
Weight Loss
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Summary:Strategies to optimize the management of obesity‐related metabolic complications after liver transplantation (LT) are needed. We examined the effect of pre‐LT sleeve gastrectomy (SG), as compared to medical weight loss (MWL), on post‐LT outcomes. This is a cohort study of adults (≥18 years) with medically complicated obesity who were eligible for pre‐LT SG and underwent LT from January 1, 2006 to June 1, 2016. Logistic regression models evaluated the association of SG on post‐LT diabetes and hypertension, defined as new‐onset or progressive disease post‐LT. Cox regression models evaluated the association of SG on recurrent and de novo nonalcoholic fatty liver disease (NAFLD). Among 70 LT recipients who were eligible for pre‐LT SG, 14 (20%) underwent SG and 56 (80%) underwent MWL only. Mean follow‐up was 5.2 years post‐LT. The SG cohort sustained higher % total body weight loss at 3 years post‐LT (28.9% vs. 5.4%, p 
ISSN:1600-6135
1600-6143
DOI:10.1111/ajt.16583