Minimally Invasive Sleeve Gastrectomy as a Surgical Treatment for Nonalcoholic Fatty Liver Disease in Liver Transplant Recipients

Transplant Proc. 2020 Jan-Feb;52(1):276-283. doi: 10.1016/j.transproceed.2019.11.014. Epub 2019 Dec 27.

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.

MeSH terms

  • Adult
  • Bariatric Surgery / methods*
  • Female
  • Gastrectomy / methods*
  • Humans
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Non-alcoholic Fatty Liver Disease / complications
  • Non-alcoholic Fatty Liver Disease / surgery*
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*
  • Postoperative Complications / surgery
  • Transplant Recipients