Combination of liver transplant and surgery for weight reduction benefits long-term obese patients
Combination of liver transplant and surgery for weight reduction benefits long-term obese patients
Combination of liver transplant and surgery for weight reduction benefits long-term obese patients
Obese patients who simultaneously underwent liver salvage procedures and weight reduction surgery were able to maintain better long-term weight and had fewer metabolic complications than those who lost weight on their own before undergoing liver transplantation. a Mayo Clinic study. The results are published in Hepatology.
"The study reveals that the combined method of liver transplantation and surgery for weight reduction is safe and effective in the long term," explains the expert author of the work, Dr. Julie K. Heimbach transplant surgeon and surgical director of Liver Transplants in May. Clinic
The rates of obesity in the United States have skyrocketed and the same has happened with the number of people diagnosed with non-alcoholic fatty liver disease, a group of liver diseases that affects people who drink little or no alcohol and leads to the storage of excessive amounts of alcohol. amount of fat in the liver cells. It is estimated that 80 or 100 million Americans have been diagnosed with chronic liver disease. Traditionally, the possibility of a liver transplant has been denied to patients with severe obesity who are not able to lose the necessary weight, because obesity increases the surgical risks and is a possible risk factor for complications after transplantation. In other situations, on the other hand, transplants are done without addressing the patient's weight problem, which can lead to future liver disease and jeopardize the transplant.
The study included a total of 49 adults with a body mass index greater than 35 kg / m2 and referred to Mayo Clinic for liver transplantation since 2006. Of those patients, 36 lost enough weight to reach a body mass index of less than 35 kg / m2 and underwent only liver transplantation. In general, there were 29 patients who could not lose enough weight before transplantation and, therefore, underwent a liver transplant combined with sleeve gastrectomy; In 13 of them, at least 3 years have passed since surgery, which was the center of the study. Sleeve gastrectomy is a type of surgery for weight reduction that decreases the size of the stomach by about 80 percent.
The scientists found that while patients undergoing liver transplantation alone lost a lot of weight before surgery, they recovered it continuously later. The percentage of total body weight recovered ended up being higher among patients who underwent liver transplantation only, unlike what happened in those who underwent liver transplantation and sleeve gastrectomy. Three years after surgery, the weight lost by patients with only liver transplantation remained at a median of 3.9 percent of total body weight, compared to 34.8 percent in transplant patients and surgery for weight reduction. In addition, patients with double surgery showed less propensity for high blood pressure, insulin resistance and fatty liver. They also required less medication to reduce blood pressure and cholesterol.
"Obesity-related liver disease is one of the most common and growing reasons why people need a liver transplant. Although most obese people will never need a transplant, those who develop advanced liver disease need a method to treat not only the liver disease but also the cause of the disease, "concludes Dr. Heimbach. (Source: Mayo Clinic)
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