Bariatric surgery and liver transplantation, here we are now: A French nationwide retrospective study

At the time of the growing obesity epidemic worldwide, liver transplantation (LT) and metabolic syndrome are closely linked: non-alcohol-related fatty liver disease (NAFLD) is one of the leading indications for liver transplantation, and metabolic syndrome can also appear after liver transplantation, in relation to immunosuppressive medications and weight gain, what-ever was the initial liver disease leading to the indication of LT. Therefore, the role of bariatric surgery (BS) is important due to its longer-lasting effect and efficacy. We performed a retrospec-tive review of all 50 adult French liver transplant recipients who had a history of bariatric sur-gery, including 37 procedures before transplantation, and 14 after. There were three significantly different characteristics when comparing pre-and post-LT BS: patients were older (at the time of BS), presented more frequently arterial hypertension (at the time of LT), and the proportion of NAFLD as initial liver disease leading to LTwas lower, in the post-LT group. Regard-ing pre-LT BS, in one case BS was complicated by liver failure leading to the rapid indication of LT; it was the single patient for whom the delay between BS and LTwas less than 1 year; there was no patient who specifically underwent BS for the purpose of LT listing.& COPY; 2023 Elsevier Masson SAS. All rights reserved.

Automated summary

During the obesity epidemic, liver transplantation and metabolic syndrome closely interact, as non-alcohol-related fatty liver disease is a common indication for liver transplantation, and metabolic syndrome can occur after transplantation due to immunosuppressive medications and weight gain. Bariatric surgery plays an important role in managing these conditions due to its long-lasting effectiveness. A retrospective study was conducted on French liver transplant recipients who had a history of bariatric surgery, revealing differences in patient characteristics and liver disease between pre- and post-transplantation bariatric surgery cases.