25 February 2015 : Case report
The First Polish Liver Transplantation after Roux-en-Y Gastric Bypass Surgery for Morbid Obesity: A Case Report and Literature ReviewRafał MarszałekBCDEF, Paweł ZiemiańskiCD, Beata ŁągiewskaCF, Marek PacholczykAB, Justyna Domienik-KarłowiczBF, Janusz TrzebickiBC, Zbigniew WierzbickiDF, Krzysztof JankowskiBF, Maciej KosieradzkiBC, Dariusz WasiakCD, Maurycy JonasCD, Piotr PruszczykBF, Magdalena DurlikCD, Wojciech LisikABCDEFG, Andrzej ChmuraDG
Ann Transplant 2015; 20:112-115
BACKGROUND: Morbid obesity is associated with liver pathology, most commonly non-alcoholic steatohepatitis (NASH) leading to cirrhosis. However, the morbid obesity impedes qualification for organ transplantation.
CASE REPORT: We present a case report of a 56-year-old woman who underwent bariatric procedure followed by liver transplantation (LTx). Her initial weight was 130.2 kg (BMI 50.9 kg/m2). The patient had a history of arterial hypertension, diabetes, gonarthrosis, and obstructive sleep apnea syndrome and no history of alcohol abuse. She underwent Roux-en-Y gastric bypass (RYGB) procedure. The routine intraoperative liver biopsy revealed fibrosis (III°), steatosis (II°), and intra-acinar inﬂammation. The operation led to a substantial loss of weight. Two years after the surgery the patient was referred to the Transplantation Clinic of Department of General Surgery and Transplantology with suspicion of liver failure due to advanced cirrhosis, which could be a result of previously diagnosed NASH and, probably, excessive alcohol use after bariatric surgery. The patient was qualified for elective LTx, which was performed 3 years after the RYGB. Immediately before LTx, the patient’s weight was 65 kg (BMI 25.4 kg/m2). The postoperative period was complicated by bleeding into the peritoneal cavity, which required reoperation. She also had renal failure, requiring renal replacement therapy. One year after LTx, she showed stable liver function with normal transaminases activity and bilirubin concentration, remission of diabetes, and good renal function.
CONCLUSIONS: Steatohepatitis in morbidly obese patients may lead to cirrhosis. Bariatric procedure can be a bridge to liver transplantation for morbidly obese patients with advanced liver fibrosis.
Keywords: Bariatric Surgery, Fatty Liver, Liver Transplantation, Obesity
04 Aug 2022 : Original articleLong-Term Patency of All-in-One Sleeve Patch Graft Venoplasty in 16 Patients Who Underwent Living Donor Liv...
Ann Transplant In Press; DOI: 10.12659/AOT.936888
22 Jul 2022 : Original articleDiagnostic Role of Tumor Markers for Hepatocellular Carcinoma in Liver Transplantation Candidates: An Analy...
Ann Transplant In Press; DOI: 10.12659/AOT.936937
22 Jul 2022 : Original articleDevelopment of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-R...
Ann Transplant In Press; DOI: 10.12659/AOT.936732
Most Viewed Current Articles
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
24 Jul 2020 : Review articleKidney Transplantation in the Times of COVID-19 – A Literature Review
Ann Transplant 2020; 25:e925755