Division of Transplantation Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Curr Opin Organ Transplant. 2018 Apr;23(2):244-249. doi: 10.1097/MOT.0000000000000513.
The epidemic of obesity is having a marked impact on liver transplant candidates and recipients, and optimal approach for the obese liver transplant patient is not yet defined. The current review summarizes the role of bariatric surgery in obese liver transplant patients.
NASH is now the second most common indication for listing for liver transplantation and is the third most common reason for patients undergoing liver transplantation. Recent reports of outcomes for obese recipients demonstrate satisfactory patient and graft survival, though complication rates may be higher. The impact of weight loss on long-term health in the nontransplant population, including those with liver disease, has been demonstrated, though less in known on the impact for weight loss and bariatric surgery for liver transplant recipients.
Obesity-related liver disease has become one of the most common indications for liver transplantation and further research is needed to determine the role of bariatric surgery in the optimal management of this population.
肥胖症的流行对肝移植候选者和受者产生了显著影响,肥胖肝移植患者的最佳治疗方法尚未明确。本综述总结了减重手术在肥胖肝移植患者中的作用。
非酒精性脂肪性肝炎(NASH)目前是肝移植适应证的第二大常见原因,也是肝移植患者的第三大常见原因。最近有关肥胖受者结局的报道表明,患者和移植物的存活率令人满意,但并发症发生率可能更高。在非移植人群中,包括患有肝病的人群,体重减轻对长期健康的影响已得到证实,但对于肝移植受者的体重减轻和减重手术的影响知之甚少。
肥胖相关肝病已成为肝移植最常见的适应证之一,需要进一步研究来确定减重手术在该人群的最佳管理中的作用。