Background: Morbid obesity is a worldwide epidemic closely linked to Non-Alcoholic Fatty Liver Disease (NAFLD), an ever more relevant indication for Liver Transplantation (LT). Obesity affects an increasing number of LT recipients, but the ideal management of these patients remain unclear. Bariatric surgery (BS) in LT setting is challenging but feasible, although the debate is still open about the best timing of bariatric surgery. Herein we report a case of high-priority LT and simultaneous sleeve gastrectomy (SG) in an obese young adult.Case report: A 45 years old man with morbid obesity (BMI 46 kg/m(2)) and severe NAFLD-related end-stage liver disease (ESLD) underwent simultaneous LT and sleeve gastrectomy (SG) in an emergency setting, due to a MELD score of 32. He had substantial weight loss during long-term follow-up and enjoyed resolution of diabetes and hypertension. At 4 years follow-up, he has normal allograft function with appropriate immunosuppressant blood levels and no ultrasound evidence of steatosis.Conclusion: In selected patients, combined LT and SG present several advantages in terms of transplant outcomes, weight loss and resolution of obesity-related comorbidities. In addition, it can be performed in the high-priority setting in case of severe ESLD with good results in the short-and long-term.

Anselmo, A., Siragusa, L., Sensi, B., Bacchiocchi, G., Pellicciaro, M., Manzia, T.m., et al. (2022). High-priority liver transplantation and simultaneous sleeve gastrectomy in MELD 32 end-stage liver disease: a case report with long-term follow-up. OBESITY RESEARCH & CLINICAL PRACTICE, 16(1), 91-94 [10.1016/j.orcp.2022.01.001].

High-priority liver transplantation and simultaneous sleeve gastrectomy in MELD 32 end-stage liver disease: a case report with long-term follow-up

Anselmo, Alessandro;Manzia, Tommaso Maria;Gentileschi, Paolo;Tisone, Giuseppe
2022

Abstract

Background: Morbid obesity is a worldwide epidemic closely linked to Non-Alcoholic Fatty Liver Disease (NAFLD), an ever more relevant indication for Liver Transplantation (LT). Obesity affects an increasing number of LT recipients, but the ideal management of these patients remain unclear. Bariatric surgery (BS) in LT setting is challenging but feasible, although the debate is still open about the best timing of bariatric surgery. Herein we report a case of high-priority LT and simultaneous sleeve gastrectomy (SG) in an obese young adult.Case report: A 45 years old man with morbid obesity (BMI 46 kg/m(2)) and severe NAFLD-related end-stage liver disease (ESLD) underwent simultaneous LT and sleeve gastrectomy (SG) in an emergency setting, due to a MELD score of 32. He had substantial weight loss during long-term follow-up and enjoyed resolution of diabetes and hypertension. At 4 years follow-up, he has normal allograft function with appropriate immunosuppressant blood levels and no ultrasound evidence of steatosis.Conclusion: In selected patients, combined LT and SG present several advantages in terms of transplant outcomes, weight loss and resolution of obesity-related comorbidities. In addition, it can be performed in the high-priority setting in case of severe ESLD with good results in the short-and long-term.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/18
English
Bariatric surgery
Liver transplantation
Sleeve gastrectomy
Follow-Up Studies
Gastrectomy
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Weight Loss
End Stage Liver Disease
Laparoscopy
Liver Transplantation
Non-alcoholic Fatty Liver Disease
Obesity, Morbid
Anselmo, A., Siragusa, L., Sensi, B., Bacchiocchi, G., Pellicciaro, M., Manzia, T.m., et al. (2022). High-priority liver transplantation and simultaneous sleeve gastrectomy in MELD 32 end-stage liver disease: a case report with long-term follow-up. OBESITY RESEARCH & CLINICAL PRACTICE, 16(1), 91-94 [10.1016/j.orcp.2022.01.001].
Anselmo, A; Siragusa, L; Sensi, B; Bacchiocchi, G; Pellicciaro, M; Manzia, Tm; Gentileschi, P; Tisone, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/306457
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