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Bariatric Surgery and Liver Transplantation: a Systematic Review a New Frontier for Bariatric Surgery

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Abstract

This study aims to conduct a systematic review on bariatric surgery (BS) for patients in the setting of liver transplantation (LT). A literature review was conducted on the PubMed, Embase, and Cochrane Library databases. Studies in the English language on adults reporting on BS prior to, during, or after LT were included. Eleven studies with 56 patients were retrieved. Two studies reported on BS before, two during, and seven after LT. Sleeve gastrectomy was the most common procedure, followed by Roux-en-Y gastric bypass, biliopancreatic diversion, and gastric banding. The overall mortality rate was nil in the early postoperative period and 5.3 % in the first postoperative year. The reoperation rate was 12.2 %. Obesity surgery seems feasible in this population, but mortality and morbidity are higher.

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References

  1. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3–21. doi:10.1111/j.1753-4887.2011.00456.x.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Blackburn GL, Mun EC. Effects of weight loss surgeries on liver disease. Semin Liver Dis. 2004;24(4):371–9.

    Article  PubMed  Google Scholar 

  3. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346(16):1221–31.

    Article  CAS  PubMed  Google Scholar 

  4. Nomura H, Kashiwagi S, Hayashi J, et al. Prevalence of fatty liver in a general population of Okinawa, Japan. Jpn J Med. 1988;27(2):142–9.

    Article  CAS  PubMed  Google Scholar 

  5. Bellentani S, Saccoccio G, Masutti F, et al. Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med. 2000;132(2):112–7.

    Article  CAS  PubMed  Google Scholar 

  6. Luyckx FH, Desaive C, Thiry A, et al. Liver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty. Int J Obes Relat Metab Disord. 1998;22(3):222–6.

    Article  CAS  PubMed  Google Scholar 

  7. Agopian VG, Kaldas FM, Hong JC, et al. Liver transplantation for nonalcoholic steatohepatitis: the new epidemic. Ann Surg. 2012;256(4):624–33. doi:10.1097/SLA.0b013e31826b4b7e.

    Article  PubMed  Google Scholar 

  8. Mandell MS, Zimmerman M, Campsen J, et al. Bariatric surgery in liver transplant patients: weighing the evidence. Obes Surg. 2008;18(12):1515–6. doi:10.1007/s11695-008-9712-7.

    Article  PubMed  Google Scholar 

  9. Angulo P. Nonalcoholic fatty liver disease and liver transplantation. Liver Transpl. 2006;12(4):523–34.

    Article  PubMed  Google Scholar 

  10. Segev DL, Thompson RE, Locke JE, et al. Prolonged waiting times for liver transplantation in obese patients. Ann Surg. 2008;248(5):863–70. doi:10.1097/SLA.0b013e31818a01ef.

    Article  PubMed  Google Scholar 

  11. Perkins JD. Influence of obesity with concurrent diseases on liver transplant survival. Liver Transpl. 2007;13(6):928–9.

    Article  PubMed  Google Scholar 

  12. Hafeez S, Ahmed MH. Bariatric surgery as potential treatment for nonalcoholic fatty liver disease: a future treatment by choice or by chance. J Obes. 2013;2013:839275. doi:10.1155/2013/839275.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Auclair M, Martel G, Lapointe R. Successful orthotopic liver transplantation after biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis. 2013;9(3):e46–8. doi:10.1016/j.soard.2012.12.005.

    Article  PubMed  Google Scholar 

  14. Burke GW, Cirocco R, Hensley G, et al. Liver transplantation for cirrhosis following jejuno-ileal bypass—regional cytokine differences associated with pathological changes in the transplant liver. Transplantation. 1992;54(2):374–7.

    Article  PubMed  Google Scholar 

  15. D’Albuquerque L. Liver transplantation for subacute hepatocellular failure due to massive steatohepatitis after bariatric surgery. Liver Transplant. 2008;14(6):881–5. doi:10.1002/lt.21472.

    Article  Google Scholar 

  16. D’Souza-Gburek SM, Batts KP, Nikias GA, et al. Liver transplantation for jejunoileal bypass-associated cirrhosis: allograft histology in the setting of an intact bypassed limb. Liver Transpl Surg. 1997;3(1):23–7.

    PubMed  Google Scholar 

  17. Lowell JA, Shenoy S, Ghalib R, et al. Liver transplantation after jejunoileal bypass for morbid obesity. J Am Coll Surg. 1997;185(2):123–7.

    Article  CAS  PubMed  Google Scholar 

  18. Castillo J, Fábrega E, Escalante CF, et al. Liver transplantation in a case of steatohepatitis and subacute hepatic failure after biliopancreatic diversion for morbid obesity. Obes Surg. 2001;11(5):640–2.

    Article  CAS  PubMed  Google Scholar 

  19. Markowitz JS, Seu P, Goss JA, et al. Liver transplantation for decompensated cirrhosis after jejunoileal bypass: a strategy for management. Transplantation. 1998;65(4):570–2.

    Article  CAS  PubMed  Google Scholar 

  20. Takata MC, Campos GM, Ciovica R, et al. Laparoscopic bariatric surgery improves candidacy in morbidly obese patients awaiting transplantation. Surg Obes Relat Dis. 2008;4(2):159–64. doi:10.1016/j.soard.2007.12.009. discussion 164–5.

    Article  PubMed  Google Scholar 

  21. Lin MYC, Mehdi Tavakol M, Sarin A, et al. Laparoscopic sleeve gastrectomy is safe and efficacious for pretransplant candidates. Surg Obes Relat Dis. 2013;9(5):653–8. doi:10.1016/j.soard.2013.02.013.

    Article  PubMed  Google Scholar 

  22. Campsen J, Zimmerman M, Shoen J, et al. Adjustable gastric banding in a morbidly obese patient during liver transplantation. Obes Surg. 2008;18(12):1625–7. doi:10.1007/s11695-008-9633-5.

    Article  PubMed  Google Scholar 

  23. Heimbach JK, Watt KDS, Poterucha JJ, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant. 2013;13(2):363–8. doi:10.1111/j.1600-6143.2012.04318.x.

    Article  CAS  PubMed  Google Scholar 

  24. Tichansky DS, Madan AK. Laparoscopic Roux-en-Y gastric bypass is safe and feasible after orthotopic liver transplantation. Obes Surg. 2005;15(10):1481–6.

    Article  PubMed  Google Scholar 

  25. Elli EF, Masrur MA, Giulianotti PC. Robotic sleeve gastrectomy after liver transplantation. Surg Obes Relat Dis. 2013;9(1):e20–2. doi:10.1016/j.soard.2012.01.010.

    Article  PubMed  Google Scholar 

  26. Al-Nowaylati A-R, Al-Haddad BJS, Dorman RB, et al. Gastric bypass post liver transplant. Liver Transpl. 2013;19(12):1324–9. doi:10.1002/lt.23734.

    Article  PubMed  Google Scholar 

  27. Gentileschi P, Venza M, Benavoli D, et al. Intragastric balloon followed by biliopancreatic diversion in a liver transplant recipient: a case report. Obes Surg. 2009;19(10):1460–3. doi:10.1007/s11695-009-9877-8.

    Article  PubMed  Google Scholar 

  28. Butte JM, Devaud N, Jarufe NP, et al. Sleeve gastrectomy as treatment for severe obesity after orthotopic liver transplantation. Obes Surg. 2007;17(11):1517–9.

    Article  PubMed  Google Scholar 

  29. Lin MYC, Tavakol MM, Sarin A, et al. Safety and feasibility of sleeve gastrectomy in morbidly obese patients following liver transplantation. Surg Endosc. 2012;27(1):81–5. doi:10.1007/s00464-012-2410-5.

    Article  PubMed  Google Scholar 

  30. Duchini A, Brunson ME. Roux-en-Y gastric bypass for recurrent nonalcoholic steatohepatitis in liver transplant recipients with morbid obesity. Transplantation. 2001;72(1):156–9.

    Article  CAS  PubMed  Google Scholar 

  31. Wang S, Li P, Sun XF, et al. Comparison between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding for morbid obesity: a meta-analysis. Obes Surg. 2013;23(7):980–6. doi:10.1007/s11695-013-0893-3.

    Article  PubMed Central  PubMed  Google Scholar 

  32. O’Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257(1):87–94. doi:10.1097/SLA.0b013e31827b6c02.

    Article  PubMed  Google Scholar 

  33. Yang X, Yang G, Wang W, et al. A meta-analysis: to compare the clinical results between gastric bypass and sleeve gastrectomy for the obese patients. Obes Surg. 2013;23(7):1001–10. doi:10.1007/s11695-013-0938-7.

    Article  PubMed  Google Scholar 

  34. Chakravarty PD, McLaughlin E, Whittaker D, et al. Comparison of laparoscopic adjustable gastric banding (LAGB) with other bariatric procedures; a systematic review of the randomised controlled trials. Surgeon. 2012;10(3):172–82. doi:10.1016/j.surge.2012.02.001.

    Article  CAS  PubMed  Google Scholar 

  35. Sarkhosh K, Birch DW, Sharma A, et al. Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon’s guide. Can J Surg. 2013;56(5):347–52.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Marterre WF, Hariharan S, First MR, et al. Gastric bypass in morbidly obese kidney transplant recipients. Clin Transplant. 1996;10(5):414–9.

    CAS  PubMed  Google Scholar 

  37. Alexander JW, Goodman H. Gastric bypass in chronic renal failure and renal transplant. Nutr Clin Pract. 2007;22(1):16–21.

    Article  PubMed  Google Scholar 

  38. Duailibi DF, Ribeiro MAF. Biliary complications following deceased and living donor liver transplantation: a review. Transplant Proc. 2010;42(2):517–20. doi:10.1016/j.transproceed.2010.01.017.

    Article  CAS  PubMed  Google Scholar 

  39. Verdonk R, Buis C. Anastomotic biliary strictures after liver transplantation: causes and consequences. Liver Transplant. 2006;12(5):726–35.

    Article  Google Scholar 

  40. Laštovičková J, Peregrin J. Biliary strictures after orthotopic liver transplantation: long-term results of percutaneous treatment in patients with nonfeasible endoscopic therapy. Transplant Proc. 2012;44(5):1379–84. doi:10.1016/j.transproceed.2012.02.026.

    Article  PubMed  Google Scholar 

  41. Nguyen NT, Nguyen B, Gebhart A, et al. Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252–7. doi:10.1016/j.jamcollsurg.2012.10.003.

    Article  PubMed  Google Scholar 

  42. Stroh C, Birk D, Flade-Kuthe R, et al. A nationwide survey on bariatric surgery in Germany—results 2005–2007. Obes Surg. 2009;19(1):105–12. doi:10.1007/s11695-008-9736-z. Epub 2008 Oct 22.

    Article  PubMed  Google Scholar 

  43. Marsk R, Freedman J, Tynelius P, et al. Antiobesity surgery in Sweden from 1980 to 2005: a population-based study with a focus on mortality. Ann Surg. 2008;248(5):777–81. doi:10.1097/SLA.0b013e318189b0cf.

    Article  PubMed  Google Scholar 

  44. Lomanto D, Lee W, Goel R, et al. Bariatric surgery in Asia in the last 5 years (2005–2009). Obes Surg. 2012;22(3):502–6. doi:10.1007/s11695-011-0547-2.

    Article  PubMed  Google Scholar 

  45. Lazzati A, Guy-Lachuer R, Delaunay V, et al. Bariatric surgery trends in France: 2005–2011. Surg Obes Relat Dis. 2014;10(2):328–34. doi:10.1016/j.soard.2013.07.015.

    Article  PubMed  Google Scholar 

  46. Perez-Protto SE, Quintini C, Reynolds LF, et al. Comparable graft and patient survival in lean and obese liver transplant recipients. Liver Transpl. 2013;19(8):907–15. doi:10.1002/lt.23680.

    Article  PubMed  Google Scholar 

  47. Murray KF, Carithers RL. AASLD practice guidelines: evaluation of the patient for liver transplantation. Hepatology. 2005;41(6):1407–32.

    Article  PubMed  Google Scholar 

  48. Shimizu H, Phuong V, Maia M, et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis. 2013;9(1):1–6. doi:10.1016/j.soard.2012.07.021.

    Article  PubMed  Google Scholar 

  49. Dallal RM, Mattar SG, Lord JL, et al. Results of laparoscopic gastric bypass in patients with cirrhosis. Obes Surg. 2004;14(1):47–53.

    Article  PubMed  Google Scholar 

  50. Brolin RE, Bradley LJ, Taliwal RV. Unsuspected cirrhosis discovered during elective obesity operations. Arch Surg. 1998;133(1):84–8.

    Article  CAS  PubMed  Google Scholar 

  51. Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol. 2011;9(10):897–901. doi:10.1016/j.cgh.2011.07.007.

    Article  PubMed  Google Scholar 

  52. Morino M, Toppino M, Forestieri P, et al. Mortality after bariatric surgery. Ann Surg. 2007;246(6):1002–9.

    Article  PubMed  Google Scholar 

  53. Nguyen NT, Nguyen B, Smith B, et al. Proposal for a bariatric mortality risk classification system for patients undergoing bariatric surgery. Surg Obes Relat Dis. 2013;9(2):239–46. doi:10.1016/j.soard.2011.12.010.

    Article  PubMed  Google Scholar 

  54. Richards J, Gunson B, Johnson J, et al. Weight gain and obesity after liver transplantation. Transpl Int. 2005;18(4):461–6.

    Article  PubMed  Google Scholar 

  55. Choudhary N, Saigal S, Saraf N. Innovative approach using an intragastric balloon for weight loss in a morbidly obese patient undergoing liver transplantation. Liver Transplant. 2012;19(2):235. doi:10.1002/lt.23567.

    Article  Google Scholar 

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Conflict of Interest

Andrea Lazzati declares no conflict of interest. Antonio Iannelli declares no conflict of interest. Anne-Sophie Schneck declares no conflict of interest. Anaïs Charles Nelson declares no conflict of interest. Sandrine Katsahian declares no conflict of interest. Jean Gugenheim declares no conflict of interest. Daniel Azoulay declares no conflict of interest.

As this study is a meta-analysis conducted on articles previously published, no informed consent is required.

For this type of study, formal consent is not required

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Correspondence to Antonio Iannelli.

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Andrea Lazzati and Antonio Iannelli equally contributed to this work.

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Table 6 Screened records

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Lazzati, A., Iannelli, A., Schneck, AS. et al. Bariatric Surgery and Liver Transplantation: a Systematic Review a New Frontier for Bariatric Surgery. OBES SURG 25, 134–142 (2015). https://doi.org/10.1007/s11695-014-1430-8

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