Abstract
Obesity is a major public health burden that affects the transplant community because of its key role in fatty liver disease and transplantation outcomes.
To evaluate the role of sleeve gastrectomy in treating recurrent and de novo nonalcoholic fatty liver disease (NAFLD) in liver transplant recipients.
A university hospital.
We describe 2 obese liver transplant recipients with recurrent and de novo NAFLD who underwent minimally invasive metabolic and bariatric surgery.
The surgery was performed successfully, with much of the operative time consumed by enterolysis. There were no intraoperative or postoperative complications. At last follow-up appointment (16 months postoperatively), there was a mean reduction in weight (31.98 kg), body mass index (10.2 kg/m2), glycosylated hemoglobin (1.05%), alanine aminotransferase (38 IU/L), steatosis score (0.34), and fibrosis score (0.05). The mean decrease in 6-month postoperative hepatic fat quantification was 6%.
These cases show that metabolic and bariatric surgery in obese, posttransplant recipients with recurrent and de novo nonalcoholic steatohepatitis lead to improved steatosis and reduced obesity and obesity-associated comorbidities.
•Nonalcoholic steatohepatitis (NASH) is the leading cause of liver transplantation.•Metabolic syndrome and recurrent NASH are prevalent among patients who are posttransplant.•Bariatric surgery and its outcomes in the transplant population are still in the exploratory stages.•This study examines the feasibility of minimally invasive sleeve gastrectomy in the setting of a posttransplant abdomen.•Two patients with posttransplant nonalcoholic fatty liver disease (NAFLD) experienced improvements in their weight, body mass index, and obesity-associated comorbidities after minimally invasive sleeve gastrectomy.•Liver transplantation and metabolic-bariatric surgery can improve survival; optimal timing of these interventions requires consideration of the severity of the individual diseases and their complex interactions.