Division of Transplantation, University of Cincinnati College of Medicine, Cincinnati Collaborative on Obesity Research, Cincinnati, OH.
Division of Transplantation Surgery, Mayo Clinic College of Medicine, Rochester, MN.
Liver Transpl. 2018 Sep;24(9):1280-1287. doi: 10.1002/lt.25303.
Nonalcoholic steatohepatitis (NASH) is projected to become the leading indication for liver transplantation (LT) in the next decade in the United States. Strategies to treat the underlying etiology of NASH, which is almost always obesity, are being pursued. One such strategy is the utilization of bariatric surgery (BS) in the peritransplant period. The use of BS prior to LT could prevent the progression of NASH and abrogate the need for LT. BS at the time of LT or postoperatively has the potential to not only improve obesity-associated conditions such as diabetes, but also the potential to influence the incidence of NASH in the post-LT setting. However, there continues to be no consensus on the use and timing of BS in this patient population. This review aims to discuss the current literature and possible future action.
非酒精性脂肪性肝炎（NASH）预计将成为未来十年美国肝移植（LT）的主要适应证。目前正在寻求治疗 NASH 根本病因的策略，而 NASH 的根本病因几乎总是肥胖。其中一种策略是在移植前使用减肥手术（BS）。LT 前使用 BS 可以预防 NASH 的进展并避免 LT 的需要。LT 时或术后使用 BS 不仅有可能改善糖尿病等与肥胖相关的疾病，还有可能影响 LT 后 NASH 的发生率。然而，在这一患者群体中，BS 的使用和时机仍没有共识。本文旨在讨论当前的文献和可能的未来行动。
