The clinical experience with bariatric surgery before and after liver transplantation, and bariatric surgery in patients with liver disease in the Northern Netherlands. [copy]

liver transplantation bariatric surgery steatosis hepatis

FGI van Vilsteren
M. Kaijser

Nature of the research:
Retrospective cohort study

Fields of study:
surgery gastroenterology

Background / introduction
As a reflection of the worldwide obesity epidemic, the prevalence of obesity in potential liver transplant recipients is rising, as well as the number of patients transplanted for cirrhosis due to non-alcoholic steatohepatitis (NASH). Bariatric surgery has been shown an effective and durable treatment option for patients with severe obesity. The optimal timing of bariatric surgery in obese patients that are current or future liver transplantation candidates is unknown. Also, the role of bariatric surgery in patients with liver diseases other than NASH potentially resulting in cirrhosis, has to be assessed.
Research question / problem definition
To assess the current clinical experience with bariatric surgery before and after liver transplantation; to assess the current clinical experience with bariatric surgery in patients with liver disease, in two expert centers for bariatric surgery and liver transplantation, resp.
The student will complete two databases (1. bariatric surgery and liver transplantation, UMCG, 2. bariatric surgery and liver disease, MCL) with relevant patient information, perform statistical analysis, and write a report on the findings. Data collection will be performed at UMCG and MC Leeuwarden. The student will work under direct supervision of staff gastroenterologist and surgeon. Expected duration of project: 3-4 months.
• Diwan et al. Liver Transplantation and Bariatric Surgery: Timing and Outcomes. Liver Transplantation 24 1280‒1287 2018 AASLD.
• Younus et al. Bariatric Surgery in Cirrhotic Patients: Is It Safe? Obesity Surgery 2019 December 18
• Heimbach et al. Combined Liver Transplantation and Gastric Sleeve Resection for Patients With Medically Complicated Obesity and End-Stage Liver Disease. American Journal of Transplantation 2013; 13: 363–368
• Zamora-Valdes et al. Long-Term Outcomes of Patients Undergoing Simultaneous Liver Transplantation and Sleeve Gastrectomy. Hepatology, Vol. 68, No. 2, 2018
• Udelsman et al. Risk factors and prevalence of liver disease in review of 2557 routine liver biopsies performed during bariatric surgery. Surgery for Obesity and Related Diseases -(2019) 1–7.
• Van den Berg EH et al. Liver transplantation for NASH cirrhosis is not performed at the expense of major post-operative morbidity. Dig Liver Dis. 2018 Jan;50(1):68-75.
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