Liver transplantationThe Multicenter Belgian Survey on Liver Transplantation for Hepatocellular Failure after Bariatric Surgery
Section snippets
Methods
An enquiry was sent to all transplant centers in Belgium to report the number of LTs performed for liver failure after bariatric surgery. A prospective database was set up to record various demographic, clinical, and surgical parameters, focusing on the degree of hepatocellular failure, the timing of its occurrence, and the outcome after LT. The 10 patients were reported by 3 out of 6 Belgian transplant centers: Ghent (n = 5), Leuven (n = 3), and Antwerp (n = 2).
Results
One patient developed chronic liver failure after JIB. The bariatric procedure was performed in 1977. She had a body mass index (BMI) of 45 kg/m2 at the time of surgery and a postoperative decline to 26 kg/m2. The diagnosis of chronic liver failure was established in 2002, ie, 25 years after the JIB. Occurrence of signs of decompensated liver failure indicated the need for transplantation. The LT was uneventful; the JIB was dismantled at the time of transplantation to prevent a relapse of liver
Discussion
This Belgian survey has reported 10 patients who developed liver failure after bariatric surgery: 1 after JIB and 9 after BPD. Since 1970, JIB became a popular treatment for morbid obesity. Unfortunately, this operation resulted in manifold postoperative complications, including increased steatosis, lobular lymphocytic inflammation, and pericellular fibrosis leading to cirrhosis.6 Acute liver failure after JIB has been recorded in 1.2%–11% of subjects in several reports. Some patients who
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