Bariatric surgery before, during, and after liver transplantation: a systematic review and meta-analysis
| Autor: | Chenchen Tian, Mehran Anvari, Aristithes G. Doumouras, Dennis Hong, Melissa Sam Soon, Yung Lee, Olivia Lovrics |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Sleeve gastrectomy medicine.medical_treatment Bariatric Surgery 030209 endocrinology & metabolism Liver transplantation 03 medical and health sciences 0302 clinical medicine Weight loss Weight Loss medicine Humans Contraindication business.industry Mortality rate Graft Survival Confidence interval Liver Transplantation Obesity Morbid Surgery Meta-analysis 030211 gastroenterology & hepatology medicine.symptom business Weight Loss Surgery |
| Zdroj: | Surgery for Obesity and Related Diseases. 16:1336-1347 |
| ISSN: | 1550-7289 |
| DOI: | 10.1016/j.soard.2020.05.012 |
| Popis: | Morbid obesity is considered a relative contraindication for liver transplantation (LTX) because of increased risk of complications. The aim of this study was to investigate the role of bariatric surgery before, during, and after LTX. A systematic review of MEDLINE, EMBASE, CENTRAL, and PubMed databases was performed for studies investigating bariatric surgery in patients before, during, or after LTX. Random-effects meta-analysis of proportions was used to calculate pooled effect estimates. One hundred eighty-seven patients underwent bariatric surgery before LTX (8 studies). After surgery, 82% (95% confidence interval, 62%-97%) of patients were successfully listed for LTX and 70% (95% confidence interval, 40%-93%) successfully received LTX. The 30-day mortality rate was 0%. The graft survival rate after 1 year was 70% (95% confidence interval, 30%-99%). Thirty-day minor and major complications rate was 4% and 1%, respectively. Thirty-two patients underwent bariatric surgery during LTX (2 studies). The 30-day mortality rate after surgery was 0% and 1-year graft survival was 100%. Sixty-four patients underwent bariatric surgery after LTX (9 studies). The 30-day mortality was 0%, but 5 deaths occurred beyond 30 days (7.8%). Bariatric surgery may be safe and feasible as a bridge to LTX for patients who would otherwise be ineligible and post-LTX patients for weight loss. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|