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Cited by 45Bariatric Surgery and OutcomesOrgan Transplantation Techniques and OutcomesMinimally Invasive Surgical Techniques

Delayed sleeve gastrectomy following liver transplantation: a 5-year experience

Morris, Mackenzie C., Jung, Andrew D., Kim, Young, Lee, Tiffany C., Kaiser, Tiffany E., Thompson, Jonathan R., Bari, Khurram, Shah, Shimul A. +4 more·2019·Liver Transplantation
DOI 10.1002/lt.25637
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Abstract

Obesity has become an epidemic in the United States over the past decade, and recent studies have shown this trend in the liver transplantation (LT) population. These patients may be candidates for laparoscopic sleeve gastrectomy (LSG) to promote significant and sustained weight loss to prevent recurrence of nonalcoholic steatohepatitis. However, safety remains a concern, and efficacy in this setting is uncertain. A single‐institution database from 2014 to 2018 was queried for patients undergoing LSG following LT. The selection criteria for surgery were consistent with National Institutes of Health guidelines, and patients were at least 6 months after LT. A total of 15 patients (median age, 59.0 years; Caucasian, 86.7%; and female, 60%) underwent LSG following LT. Median time from LT to LSG was 2.2 years with a median follow‐up period of 2.6 years. The median hospital length of stay (LOS) was 2 days after LSG. Mortality and rate of liver allograft rejection was 0, and there was 1 postoperative complication (a surgical site infection). Following LSG, body mass index (BMI) decreased from 42.7 to 35.9 kg/m2 (P < 0.01), and in 12 patients with at least 1 year of follow‐up, the total body weight loss was 20.6%. Following LSG in patients with diabetes, the median daily insulin requirements decreased from 98 (49‐118) to 0 (0‐29) units/day (P = 0.02), and 60% discontinued insulin. Post‐LT patients had a similar decrease in BMI and reduction in comorbidities at 1 year compared with a matched non‐LT patient cohort. In the largest patient series to date, we show that LSG following LT is safe, effective, and does not increase the incidence of liver allograft rejection. Larger longer‐term studies are needed to confirm underlying metabolic changes following LSG.

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  • Delayed sleeve gastrectomy following liver transplantation (2-year median delay) has been reported in a small series without mortality or graft loss and with a body weight loss of 20% with improvement in diabetes control and lesser diabetes medication.

    “Delayed sleeve gastrectomy following liver transplantation (2-year median delay) has been reported in a small series 524 without mortality or graft loss and with a body weight loss of 20% with improvement in diabetes control and lesser diabetes medication.”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [524]

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Authors
Morris, M. C., Jung, A. D., Kim, Y., Lee, T. C., Kaiser, T. E., Thompson, J. R., Bari, K., Shah, S. A., Cohen, R. M., Schauer, D. P., Smith, E. P., & Diwan, T. S.
Affiliations
University of Cincinnati (US)
Corresponding author
Diwan, Tayyab S.
ORCID
Venue
Liver Transplantation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-10-15
Volume
25
Issue
11
Pages
1673-1681
ISSN
  • 1527-6465 (ISSN-L)
  • 1527-6473
DOI
10.1002/lt.25637
OpenAlex
W2972780542
Cited by
45
References
35
Citations by year
2026: 6 · 2025: 9 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 6
FWCI
4.30
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Liver Transplantation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Keywords
laparoscopic sleeve gastrectomy, obesity, weight loss, nonalcoholic steatohepatitis, liver allograft rejection, diabetes mellitus, insulin requirement, surgical safety, postoperative complications
MeSH terms
Female, Gastrectomy, Graft Rejection, Humans, Length of Stay, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Period, Retrospective Studies, Surgical Wound Infection, Weight Loss, Incidence, Liver Transplantation, Treatment Outcome, Bariatric Surgery, Secondary Prevention, Time-to-Treatment, Non-alcoholic Fatty Liver Disease

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