Bariatric surgery does not increase likelihood of liver transplantation in NASH
SAN DIEGO — Patients with NASH who underwent bariatric surgery were no more likely to undergo liver transplantation surgery than those without a history of bariatric surgery, according to a study presented at Digestive Disease Week.
“Obesity is directly linked with [the] development of NASH, which is one of the leading indications for liver transplantation,” Paul T. Kroner, MD, MSc, gastroenterology fellow at Mayo Clinic Florida, and colleagues wrote. “Bariatric surgery is a successful treatment option for obesity in NASH and may be performed in the pre-liver transplantation setting to improve transplant candidacy. However, the impact of previous bariatric surgery on immediate post-liver transplantation outcomes has not been studied.”
A total of 32,580 patients who underwent liver transplantation surgery were identified using ICD9-10CM codes. Within that group, 265 patients had undergone bariatric surgery. The mean age of patients was 51.5 years; 35% were women.
The researchers conducted a case-control study using National Inpatient Sample data from 2012 to 2016. Kroner and colleagues aimed to determine the likelihood of liver transplantation surgery among patients with NASH who had undergone bariatric surgery compared with patients with NASH who had not undergone bariatric surgery. Secondary outcomes included inpatient morbidity (as measured by acute kidney injury), ICU stay, acute liver transplant rejection, multiorgan failure, deep vein thrombosis and pulmonary embolism, as well as resource utilization, length of hospital stay and inflation-adjusted total hospital costs and charges.
The odds of undergoing of liver transplantation surgery did not differ between patients who had undergone bariatric surgery and those who had not. Additionally, there were no significant differences between the two groups in regard to shock, ICU stay, acute kidney injury, multiorgan failure, deep vein thrombosis, pulmonary embolism, liver transplant rejection, costs, charges or length of stay.
“Patients with a history of bariatric surgery had no different odds of undergoing liver transplant than NASH patients with no history of bariatric surgery,” Kroner and colleagues concluded. “Furthermore, this study suggests that bariatric surgery does not increase the risk of early adverse events following liver transplant during the index admission. Future studies are needed to evaluate long-term outcomes and to determine the impact on fatty liver disease in the graft.” – by Alaina Tedesco
Kroner PT, et al. Abstract Sa1594. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Kroner reports no relevant financial disclosures. Please see the abstract for all other authors’ relevant financial disclosures.