Combined sleeve gastrectomy with liver transplant in patients with obesity: a feasibility study
Abstract
Background Nonalcoholic steatohepatitis (NASH) associated with obesity is one of the leading causes of liver failure requiring transplant, yet guidelines for the management of obesity in these scenarios are not always followed. In order to decrease incidence of NASH in the new liver, we studied the feasibility of simultaneous liver transplant and bariatric surgery.Materials and methods We retrospectively identified patients who underwent simultaneous liver transplant and sleeve gastrectomy at our hospital site between November 24, 2019, and April 14, 2022. Demographics, surgical data, postoperative adverse events, and weight loss data were collected.Results Ten patients met inclusion criteria. Mean body mass index (BMI) at the time of transplant was 43.1 ± 5.3 kg/m 2, and mean length of hospital stay was 10.8 ± 5.22 days. Within 30 days after surgery, 7 patients reported adverse effects, and 2 were readmitted. Mean BMI at 6-month follow-up was 30.6 ± 2.5 kg/m 2. Mean percentage excess weight (in pounds) loss was 48.1 ± 11.4%, 58.6 ± 8.9%, and 66.1 ± 15.3% at 3-, 6-, and 12-month follow-up, respectively. Three patients had an increase in weight at 12-month follow-up when compared to 6-month follow-up. Most patients required fewer comorbidity-related medications, and none reported adverse effects related to sleeve gastrectomy.Conclusions Bariatric surgery at the time of liver transplant is safe and has minimal adverse effects. Results include substantial postoperative weight loss, improvement in comorbidities, and decreased risk of NASH in the new liver. Further studies with larger cohorts are required to confirm the findings of this study.
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Complications specifically related to laparoscopic sleeve gastrectomy are very rare.
“Complications speci fi cally related to laparoscopic sleeve gastrectomy are very rare and long-term bene fi ts have been reported with durable weight loss (35-38%) 505,506,508 and fewer metabolic complications (IR, hypertension, T2D and metabolic syndrome and less antihypertensive and lipid-lowering medication). 505,506”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [506]
In individuals with decompensated cirrhosis listed for liver transplantation, combined liver transplantation and sleeve gastrectomy can be completed successfully.
“In individuals with decompensated cirrhosis listed for liver transplantation, combined liver transplantation and sleeve gastrectomy can be completed successfully. 505,506”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [506]
Long-term benefits of laparoscopic sleeve gastrectomy have been reported with durable weight loss (35-38%) and fewer metabolic complications.
“Complications speci fi cally related to laparoscopic sleeve gastrectomy are very rare and long-term bene fi ts have been reported with durable weight loss (35-38%) 505,506,508 and fewer metabolic complications (IR, hypertension, T2D and metabolic syndrome and less antihypertensive and lipid-lowering medication). 505,506”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [506]
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- Authors
- Gunturu, N. S., Castillo-Larios, R., Bowers, S., Edwards, M., Burns, J., Perry, D., & Elli, E. F.
- Affiliations
- Mayo Clinic in Florida (US)
- Mayo Clinic (US)
- Corresponding author
- Elli, Enrique F.
- ORCID
- Venue
- Obesity Surgery
- Published
- 2022-09-28
- Volume
- 32
- Issue
- 11
- Pages
- 3600-3604
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W4297462938
- Cited by
- 17
- References
- 15
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 8 · 2023: 3
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Keywords
- sleeve gastrectomy, liver transplantation
- MeSH terms
- Feasibility Studies, Gastrectomy, Humans, Obesity, Obesity, Morbid, Laparoscopy, Retrospective Studies, Weight Loss, Liver Transplantation, Treatment Outcome, Non-alcoholic Fatty Liver Disease
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