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Published in: Obesity Surgery 8/2021

01-08-2021 | Liver Transplantation | Original Contributions

Liver Transplantation After Bariatric Surgery: a Clinical Cohort Study

Authors: David C. Fipps, Rachel E. Goetze, Matthew M. Clark, Kristin Mara, Kymberly D. Watt, Sheila G. Jowsey-Gregoire, Julie K. Heimbach, Karen Grothe

Published in: Obesity Surgery | Issue 8/2021

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Abstract

Purpose

Individuals that undergo bariatric surgery are at higher risk for problematic alcohol use via pharmacokinetic changes in alcohol metabolism and cross addictions. Little data exists regarding post-bariatric surgery patients with alcohol-related liver disease (ALD) who ultimately require liver transplantation. The aim of this project was to better understand demographic, medical, and psychological characteristics of post-bariatric surgery patients who undergo liver transplantation due to ALD.

Methods

This retrospective clinical cohort identified 1416 patients who underwent ALD liver transplantation over a 10-year timespan at three academic medical centers. Electronic medical records were reviewed for patient characteristics, including sex, age, body mass index, surgery dates, Model for End Stage Liver Disease (MELD) scores, medical history, psychiatric history, and mortality rates.

Results

Within the sample of liver transplantation patients, 1.3% had undergone bariatric surgery prior to transplantation. Fifty percent of the post-bariatric surgery sample was female. The MELD score was higher and the median age at transplantation was younger in the post-bariatric surgery subgroup in comparison to that in the non-bariatric surgery patients. Mood and anxiety disorders were more common among those with a history of having bariatric surgery, with major depressive disorder having the largest difference between subgroups.

Conclusions

Among patients who require a liver transplantation due to ALD, those with a history of bariatric surgery are more likely to be female, younger, and diagnosed with mood disorders. Further studies with larger and more diverse samples are necessary to better understand how to prevent development of alcohol use disorder in the bariatric surgery population.

Graphical abstract

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Metadata
Title
Liver Transplantation After Bariatric Surgery: a Clinical Cohort Study
Authors
David C. Fipps
Rachel E. Goetze
Matthew M. Clark
Kristin Mara
Kymberly D. Watt
Sheila G. Jowsey-Gregoire
Julie K. Heimbach
Karen Grothe
Publication date
01-08-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 8/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05483-x

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