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Current Hepatology Reports

Published in:

01-12-2018 | Fatty Liver Disease (Z Younossi, Section Editor)

Surgical Issues in NASH: Bariatric Surgery and Liver Transplantation

Authors: Sonali Paul, Michael Charlton

Published in: Current Hepatology Reports | Issue 4/2018

Abstract

Purpose of Review

The rising prevalence of obesity in general and non-alcoholic steatohepatitis (NASH) specifically as an indication for liver transplantation has occurred in parallel with an increase in the consideration and performance of bariatric surgery before and after liver transplantation. We review the impact and relative merits of bariatric surgery before, during, and after liver transplantation.

Recent Findings

The sleeve gastrectomy approach has several practical advantages over other forms of weight loss surgery and has been shown to improve metabolic parameters. Bariatric surgical procedures inevitably affect immunosuppression pharmacokinetics, with the least impact being observed following sleeve gastrectomy. In the non-transplant setting, bariatric surgery has been shown to be an effective therapy for histological features of NASH.

Summary

When compared to lifestyle changes alone, bariatric surgery performed during or after liver transplantation results in sustained weight loss and improved metabolic parameters associated with liver disease, cardiovascular risk, and overall mortality. Further studies are needed to confirm which surgical procedures, timing, and NASH patients will receive most benefit.

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Title: Surgical Issues in NASH: Bariatric Surgery and Liver Transplantation
Authors: Sonali Paul
Michael Charlton
Publication date: 01-12-2018
Publisher: Springer US
Published in: Current Hepatology Reports / Issue 4/2018
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-018-0429-3

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