Are We Ready for Bariatric Surgery in a Liver Transplant Program? A Meta-Analysis
| Autor: | Dilmurodjon Eshmuminov, Victor Lopez-Lopez, Francisco Sánchez-Bueno, Ricardo Robles-Campos, Kuno Lehmann, José Antonio Pons, David Ruiz de Angulo, J.J. Ruiz-Manzanera, Marcel André Schneider, Markus von der Groeben, Pablo Ramírez-Romero, Ursula Gajownik |
|---|---|
| Přispěvatelé: | University of Zurich, Lopez-Lopez, Víctor |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Sleeve gastrectomy Endocrinology Diabetes and Metabolism medicine.medical_treatment Bariatric Surgery 030209 endocrinology & metabolism 610 Medicine & health Liver transplantation 03 medical and health sciences Liver disease 0302 clinical medicine Endocrinology Gastrectomy Non-alcoholic Fatty Liver Disease Diabetes mellitus Weight Loss medicine Humans 10217 Clinic for Visceral and Transplantation Surgery Nutrition and Dietetics business.industry Fatty liver Perioperative medicine.disease Surgery 2746 Surgery Liver Transplantation Obesity Morbid Diabetes and Metabolism 2712 Endocrinology Diabetes and Metabolism Treatment Outcome 2916 Nutrition and Dietetics 030211 gastroenterology & hepatology Steatohepatitis business Body mass index |
| Zdroj: | Web of Science |
| ISSN: | 1708-0428 |
| Popis: | Obesity-related non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are two main causes of end-stage liver disease requiring a liver transplantation. Studies exploring bariatric surgery in the liver transplantation setting have increased in recent years; however, a systematic analysis of the topic is lacking to date. This meta-analysis was conducted to explore the perioperative and long-term outcomes of bariatric surgery in obese patients undergoing liver transplantation. Electronic databases were systematically searched for studies reporting bariatric surgery in patients undergoing liver transplantation. The primary outcomes were postoperative complications and mortality. We also extracted data about excess weight loss, body mass index, and improvement of comorbidities after bariatric surgery. A total of 96 patients from 8 articles were included. Bariatric surgery–related morbidity and mortality rates were 37% (95% CI 0.27–0.47) and 0.6% (95% CI 0.02–0.13), respectively. Body mass index at 24 months was 31.02 (95% CI 25.96–36.09) with a percentage excess weight loss at 12 and 24 months of 44.08 (95% CI 27.90–60.26) and 49.2 (95% CI 31.89–66.66), respectively. After bariatric surgery, rates of improvement of arterial hypertension and diabetes mellitus were 61% (95% CI 0.45–0.75) and 45% (95% CI 0.25–0.66), respectively. In most patients, bariatric surgery was performed after liver transplant and the most frequent technique was sleeve gastrectomy. Bariatric surgery can be performed safely in the setting of liver transplantation resulting in improvement of obesity-related comorbidities. The optimal timing and technique require further studies. |
| Databáze: | OpenAIRE |
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