Our Summary

This research paper investigates the use of weight loss surgery (bariatric surgery) for liver transplant patients who become severely obese due to the necessary lifelong immunosuppressive therapy after their transplant. Obesity can cause a variety of health problems for these patients, including liver inflammation and scarring (non-alcoholic steatohepatitis or NASH), liver cancer, heart disease, and a general decrease in quality of life. It also increases the risk of losing the transplanted liver.

Between 2008 and 2017, the researchers performed a specific type of bariatric surgery known as laparoscopic sleeve gastrectomy (LSG) on nine liver transplant patients. This minimally invasive procedure involves removing a large part of the stomach to limit food intake and promote weight loss.

The results show that this surgery is technically possible and largely safe for liver transplant patients, with no intra-operative complications and most patients having no issues after the surgery. However, one patient did develop a leak along the line where the stomach was stapled. More research with larger patient groups is needed to further ensure the safety and effectiveness of this procedure for liver transplant patients.

FAQs

  1. What is the purpose of using weight loss surgery for liver transplant patients?
  2. What type of bariatric surgery was performed on the liver transplant patients in the study?
  3. What were the results and complications of the laparoscopic sleeve gastrectomy on liver transplant patients?

Doctor’s Tip

A doctor might tell a patient about gastrectomy to ensure that they understand the potential risks and benefits of the procedure. They may advise the patient to follow a strict post-operative diet to aid in healing and prevent complications. Additionally, the doctor may recommend regular follow-up appointments to monitor weight loss progress and address any concerns or complications that may arise. It is important for the patient to communicate openly with their healthcare team and follow their recommendations for the best possible outcome.

Suitable For

Patients who are severely obese and have undergone liver transplantation, particularly those who have developed health problems such as liver inflammation, liver cancer, heart disease, and decreased quality of life, may be recommended for gastrectomy. In this case, laparoscopic sleeve gastrectomy (LSG) was performed on liver transplant patients who had become severely obese due to lifelong immunosuppressive therapy after their transplant.

It is important to note that each patient’s case is unique and recommendations for gastrectomy should be made on an individual basis by a medical professional. Additionally, more research is needed to further understand the safety and effectiveness of gastrectomy for liver transplant patients.

Timeline

Before gastrectomy:

  1. Patient undergoes liver transplant surgery due to liver disease.
  2. Patient is prescribed lifelong immunosuppressive therapy to prevent rejection of the transplanted liver.
  3. Patient experiences weight gain and obesity as a side effect of immunosuppressive therapy.
  4. Patient develops health problems such as liver inflammation, scarring, liver cancer, heart disease, and decreased quality of life.

After gastrectomy:

  1. Patient undergoes laparoscopic sleeve gastrectomy (LSG) to promote weight loss.
  2. Surgery is technically possible and largely safe, with no intra-operative complications for most patients.
  3. One patient develops a leak along the staple line post-surgery, requiring further medical attention.
  4. More research is needed to evaluate the long-term safety and effectiveness of LSG for liver transplant patients.

What to Ask Your Doctor

  1. Is a gastrectomy a suitable option for me as a liver transplant patient who has become severely obese due to immunosuppressive therapy?
  2. What are the potential risks and complications associated with undergoing a gastrectomy after a liver transplant?
  3. How will a gastrectomy impact my overall health and quality of life as a liver transplant patient?
  4. What is the expected recovery time and post-operative care needed after a gastrectomy for a liver transplant patient?
  5. Are there any specific dietary changes or restrictions I should follow after undergoing a gastrectomy as a liver transplant patient?
  6. Will a gastrectomy have any impact on my immunosuppressive therapy or the functioning of my transplanted liver?
  7. Are there any alternative weight loss options or treatments that may be more suitable for me as a liver transplant patient?
  8. What is the long-term prognosis and potential benefits of undergoing a gastrectomy as a liver transplant patient?
  9. How frequently will I need to follow up with my healthcare provider after undergoing a gastrectomy as a liver transplant patient?
  10. Are there any specific considerations or precautions I should be aware of before deciding to undergo a gastrectomy as a liver transplant patient?

Reference

Authors: Bou Nassif G, Salloum C, Paolino L, Azoulay D, Lazzati A. Journal: Obes Surg. 2019 Apr;29(4):1436-1438. doi: 10.1007/s11695-019-03751-5. PMID: 30725432