Skip to main content

Advertisement

Log in

The Role of Bariatric Surgery in Abdominal Organ Transplantation—the Next Big Challenge?

  • Review Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Obesity is linked to inferior transplant outcome. Bariatric surgery (BS) is an established treatment of morbid obesity. We provide an overview on BS in the field of kidney (KT) and liver transplantation (LT). In end-stage renal disease (ESRD) and KT patients, BS seems safe and feasible. Complication rates were slightly higher compared to the non-transplant population, whereas weight loss and improvement of comorbidities were comparable. Sleeve gastrectomy (SG) was the preferred procedure before KT and superior to gastric bypass (GB) in regard to mortality and morbidity. If conducted after KT, both procedures showed comparable results. BS before LT was associated with high complication rates, in particular after GB. Albeit distinct complications, SG conducted after LT showed the best results. Immunosuppression (IS) changes after BS were rare.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA [Internet]. American Medical Association; 2014 Feb 26 [cited 2014 Jul 9];311(8):806–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24570244.

  2. Lentine KL, Delos Santos R, Axelrod D, Schnitzler MA, Brennan DC, Tuttle-Newhall JE, et al. Obesity and kidney transplant candidates: how big is too big for transplantation? Am J Nephrol [Internet]. Karger Publishers; 2012 Jan [cited 2015 Jun 8];36(6):575–86. Available from: http://www.karger.com/Article/FullText/345476.

  3. Curran SP, Famure O, Li Y, et al. Increased recipient body mass index is associated with acute rejection and other adverse outcomes after kidney transplantation. Transplantation [Internet]. 2013;97(1):64–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24056619

    Article  Google Scholar 

  4. Kovesdy CP, Czira ME, Rudas A, Ujszaszi A, Rosivall L, Novak M, et al. Body mass index, waist circumference and mortality in kidney transplant recipients. Am J Transplant [Internet]. 2010 Dec [cited 2015 Jun 8];10(12):2644–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21087417.

  5. Ong JP, Younossi ZM. Epidemiology and natural history of NAFLD and NASH. Clin Liver Dis [Internet]. 2007 Feb [cited 2015 Apr 6];11(1):1–16. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17544968.

  6. Watt KDS, Charlton MR. Metabolic syndrome and liver transplantation: a review and guide to management. J Hepatol [Internet]. 2010 Jul [cited 2015 Jul 7];53(1):199–206. Available from: http://www.sciencedirect.com/science/article/pii/S0168827810001960.

  7. de Heredia FP, Gómez-Martínez S, Marcos A. Obesity, inflammation and the immune system. Proc Nutr Soc [Internet]. Cambridge University Press; 2012 May 1 [cited 2015 May 25];71(2):332–8. Available from: http://journals.cambridge.org/abstract_S0029665112000092.

  8. Nicoletto BB, Fonseca NKO, Manfro RC, et al. Effects of obesity on kidney transplantation outcomes: a systematic review and meta-analysis. Transplantation [Internet]. 2014;98(2):167–76. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24911038

    Article  Google Scholar 

  9. Meier-Kriesche HU, Vaghela M, Thambuganipalle R, Friedman G, Jacobs M, Kaplan B. The effect of body mass index on long-term renal allograft survival. Transplantation [Internet]. 1999 Nov 15 [cited 2016 Mar 13];68(9):1294–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10573066.

  10. Chang SH, Coates PTH, McDonald SP. Effects of body mass index at transplant on outcomes of kidney transplantation. Transplantation [Internet]. 2007 Oct 27 [cited 2016 Mar 13];84(8):981–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17989603.

  11. Cannon RM, Jones CM, Hughes MG, et al. The impact of recipient obesity on outcomes after renal transplantation. Ann Surg [Internet]. 2013;(5):257, 978–84. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23295317

  12. Prasad GVR, Huang M, Silver SA, Al-Lawati AI, Rapi L, Nash MM, et al. Metabolic syndrome definitions and components in predicting major adverse cardiovascular events after kidney transplantation. Transpl Int [Internet]. 2015 Jan [cited 2015 Nov 10];28(1):79–88. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25207680.

  13. Aalten J, Christiaans MH, de Fijter H, et al. The influence of obesity on short- and long-term graft and patient survival after renal transplantation. Transpl Int. 2006;19(11):901–7.

    Article  PubMed  Google Scholar 

  14. Molnar MZ, Kovesdy CP, Mucsi I, Bunnapradist S, Streja E, Krishnan M, et al. Higher recipient body mass index is associated with post-transplant delayed kidney graft function. Kidney Int [Internet]. International Society of Nephrology; 2011 Jul [cited 2015 Jul 7];80(2):218–24. Available from: doi:10.1038/ki.2011.114.

  15. Meier-Kriesche H-U, Arndorfer JA, Kaplan B. The impact of body mass index on renal transplant outcomes: a significant independent risk factor for graft failure and patient death. Transplantation [Internet]. 2002 Jan 15 [cited 2015 Jul 7];73(1):70–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11792981.

  16. Hill CJ, Courtney AE, Cardwell CR, Maxwell AP, Lucarelli G, Veroux M, et al. Recipient obesity and outcomes after kidney transplantation: a systematic review and meta-analysis. Nephrol Dial Transplant. 2015;30:1403–11. doi:10.1093/ndt/gfv214.

  17. Lynch RJ, Ranney DN, Shijie C, et al. Obesity, surgical site infection, and outcome following renal transplantation. Ann Surg. 2009;250(6):1014–20.

    Article  PubMed  Google Scholar 

  18. Kasiske BL, Zeier MG, Chapman JR, Craig JC, Ekberg H, Garvey CA, et al. Resumen de las Guías de práctica clínica KDIGO sobre el cuidado del receptor de trasplante renal. Rev Nefrol Dial y Traspl [Internet]. Nature Publishing Group; 2011;31(1):6–21. Available from: doi:10.1038/ki.2009.377

  19. Knoll G, Cockfield S, Blydt-Hansen T, Baran D, Kiberd B, Landsberg D, et al. Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation. Cmaj [Internet]. 2005 Nov 8 [cited 2015 Jun 28];173(10):1181–4. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1330435&tool=pmcentrez&rendertype=abstract.

  20. Lee MJ, Doh FM, Kim CH, Koo HM, Oh HJ, Park JT, et al. Interdialytic weight gain and cardiovascular outcome in incident hemodialysis patients. Am J Nephrol [Internet]. Karger Publishers; 2014 Jan [cited 2015 Jul 7];39(5):427–35. Available from: http://www.karger.com/Article/FullText/362743.

  21. Thoma B, Grover VK, Shoker A. Prevalence of weight gain in patients with better renal transplant function. Clin Nephrol [Internet]. 2006 Jun [cited 2015 Aug 4];65(6):408–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16792135.

  22. Takahashi Y, Fukusato T, Inui A, et al. Pediatric nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Nihon Rinsho [Internet]. 2012;70(10):1827–34. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23971751%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/23198569%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/23971751%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/23198569

    Google Scholar 

  23. Brunt EM, Tiniakos DG. Histopathology of nonalcoholic fatty liver disease. World J Gastroenterol [Internet]. 2010 Nov 14 [cited 2015 Jun 3];16(42):5286–96. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2980677&tool=pmcentrez&rendertype=abstract.

  24. Hakeem AR, Cockbain AJ, Raza SS, Pollard SG, Toogood GJ, Attia MA, et al. Increased morbidity in overweight and obese liver transplant recipients: a single-center experience of 1325 patients from the United Kingdom. Liver Transpl [Internet]. 2013 May [cited 2015 Jul 7];19(5):551–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23408499.

  25. Dare AJ, Plank LD, Phillips ARJ, Gane EJ, Harrison B, Orr D, et al. Additive effect of pretransplant obesity, diabetes, and cardiovascular risk factors on outcomes after liver transplantation. Liver Transpl [Internet]. 2014 Mar [cited 2015 Jul 7];20(3):281–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24395145.

  26. Rana A, Gruessner A, Agopian VG, Khalpey Z, Riaz IB, Kaplan B, et al. Survival benefit of solid-organ transplant in the United States. JAMA Surg [Internet]. American Medical Association; 2015 Mar 1 [cited 2015 Jul 7];150(3):252–9. Available from: http://archsurg.jamanetwork.com/article.aspx?articleid=2100153.

  27. Pelletier SJ, Maraschio MA, Schaubel DE, Dykstra DM, Punch JD, Wolfe RA, et al. Survival benefit of kidney and liver transplantation for obese patients on the waiting list. Clin Transpl [Internet]. 2003 Jan [cited 2015 Jul 7];77–88. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15387099.

  28. Nair S, Verma S, Thuluvath PJ. Obesity and its effect on survival in patients undergoing orthotopic liver transplantation in the United States. Hepatology [Internet]. 2002 Jan [cited 2015 Jun 1];35(1):105–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11786965.

  29. Rustgi VK, Marino G, Rustgi S, et al. Obesity and its effect on survival in patients undergoing orthotopic liver transplantation in the United States. Hepatology. 2002;35(6):105–9.

    Google Scholar 

  30. Mazuelos F, Abril J, Zaragoza C, Rubio E, Moreno J., Turrión V., et al. Cardiovascular morbidity and obesity in adult liver transplant recipients. Transplant Proc [Internet]. 2003 Aug [cited 2015 Jul 7];35(5):1909–10. Available from: http://www.sciencedirect.com/science/article/pii/S0041134503006407.

  31. Orci LA, Majno PE, Berney T, Morel P, Mentha G, Toso C. The impact of wait list body mass index changes on the outcome after liver transplantation. Transpl Int [Internet]. 2013;26(2):170–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23199077.

  32. VanWagner LB, Lapin B, Levitsky J, Wilkins JT, Abecassis MM, Skaro AI, et al. High early cardiovascular mortality after liver transplantation. Liver Transpl [Internet]. 2014 Nov [cited 2015 Jul 7];20(11):1306–16. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25044256.

  33. Singhal A, Wilson GC, Wima K, Quillin RC, Cuffy M, Anwar N, et al. Impact of recipient morbid obesity on outcomes after liver transplantation. Transpl Int [Internet]. 2015 Feb [cited 2015 Nov 13];28(2):148–55. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25363625.

  34. Scarborough P, Bhatnagar P, Wickramasinghe KK, et al. The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006–07 NHS costs. J Public Health (Bangkok). 2011;33(4):527–35.

    Article  Google Scholar 

  35. Patil DT, Yerian LM. Evolution of nonalcoholic fatty liver disease recurrence after liver transplantation. Liver Transpl [Internet]. 2012 Oct [cited 2015 Jul 7];18(10):1147–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22740341.

  36. Mathur A, Franco ES, Leone JP, Osman-Mohamed H, Rojas H, Kemmer N, et al. Obesity portends increased morbidity and earlier recurrence following liver transplantation for hepatocellular carcinoma. HPB (Oxford) [Internet]. 2013 Jul [cited 2015 Jul 7];15(7):504–10. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3692019&tool=pmcentrez&rendertype=abstract.

  37. Lin MYC, Tavakol MM, Sarin A, Amirkiai SM, Rogers SJ, Carter JT, et al. Laparoscopic sleeve gastrectomy is safe and efficacious for pretransplant candidates. Surg Obes Relat Dis [Internet]. Jan [cited 2015 Jun 27];9(5):653–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23701857.

  38. Kienzl-Wagner K, Pratschke J, Öllinger R. A double challenge transplant—horseshoe kidney meets obesity. First case of horseshoe kidney transplantation after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis [Internet]. 2014 Nov [cited 2015 Aug 4];10(6):e89–91 Available from: http://www.sciencedirect.com/science/article/pii/S1550728914000641.

  39. Jamal MH, Corcelles R, Daigle CR, Rogula T, Kroh M, Schauer PR, et al. Safety and effectiveness of bariatric surgery in dialysis patients and kidney transplantation candidates. Surg Obes Relat Dis [Internet]. Jan [cited 2015 Jun 27];11(2):419–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25813752.

  40. Alexander JW, Goodman H. Gastric bypass in chronic renal failure and renal transplant. Nutr Clin Pract [Internet]. 2007 Feb [cited 2015 Aug 5];22(1):16–21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17242450.

  41. Freeman CM, Woodle ES, Shi J, Alexander JW, Leggett PL, Shah SA, et al. Addressing morbid obesity as a barrier to renal transplantation with laparoscopic sleeve gastrectomy. Am J Transplant [Internet]. 2015. Available from: http://doi.wiley.com/10.1111/ajt.13116.

  42. Koshy AN, Wilkinson S, Coombes JS, Fassett RG. Laparoscopic adjustable gastric band in an obese unrelated living donor prior to kidney transplantation: a case report. J Med Case Rep [Internet]. 2010 Jan [cited 2015 Aug 4];4:107. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2862044&tool=pmcentrez&rendertype=abstract.

  43. Marszałek R, Ziemiański P, Lisik W, Wierzbicki Z, Domienik-Karłowicz J, Trzebicki J, et al. Bariatric surgery as a bridge for kidney transplantation in obese subjects. Case report. Ann Transplant [Internet]. Jan [cited 2015 Aug 4];17(1):108–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22466915.

  44. Kienzl-Wagner K, Weissenbacher A, Gehwolf P, Wykypiel H, Öfner D, Schneeberger S. Laparoscopic sleeve gastrectomy: gateway to kidney transplantation. Surg Obes Relat Dis [Internet]. 2017 Jan 6 [cited 2017 Jun 5]; Available from: http://linkinghub.elsevier.com/retrieve/pii/S1550728917300060.

  45. Modanlou KA, Muthyala U, Xiao H, Schnitzler MA, Salvalaggio PR, Brennan DC, et al. Bariatric surgery among kidney transplant candidates and recipients: analysis of the United States renal data system and literature review. Transplantation [Internet]. 2009 Apr 27 [cited 2015 Aug 4];87(8):1167–73. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2833328&tool=pmcentrez&rendertype=abstract.

  46. Khoraki J, Katz MG, Funk LM, Greenberg JA, Fernandez LA, Campos GM. Feasibility and outcomes of laparoscopic sleeve gastrectomy after solid organ transplantation. Surg Obes Relat Dis [Internet]. 2015 Apr 9 [cited 2015 Jun 27]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/26048513.

  47. Golomb I, Winkler J, Ben-Yakov A, et al. Laparoscopic sleeve gastrectomy as a weight reduction strategy in obese patients after kidney transplantation. Am J Transplant [Internet]. 2014;14(10):2384–90. Available from: http://doi.wiley.com/10.1111/ajt.12829

    Article  CAS  Google Scholar 

  48. Marterre WF, Hariharan S, First MR, Alexander JW. Gastric bypass in morbidly obese kidney transplant recipients. Clin Transplant [Internet]. 1996 Oct [cited 2015 Aug 4];10(5):414–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8930454.

  49. Chmura A, Ziemiański P, Lisik W, Marszałek RJ, Cieciura T, Domienik-Karłowicz J, et al. Improvement of graft function following Roux-en-Y gastric bypass surgery in a morbidly obese kidney recipient: a case report and literature review. Ann Transplant [Internet]. 2014 Jan [cited 2015 Aug 5];19:639–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25483934.

  50. Szomstein S, Rojas R, Rosenthal RJ. Outcomes of laparoscopic bariatric surgery after renal transplant. Obes Surg [Internet]. 2009 Sep 25 [cited 2015 Aug 4];20(3):383–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19779949.

  51. Takata MC, Campos GM, Ciovica R, Rabl C, Rogers SJ, Cello JP, et al. Laparoscopic bariatric surgery improves candidacy in morbidly obese patients awaiting transplantation. Surg Obes Relat Dis [Internet]. 2008 Jan [cited 2015 Aug 5];4(2):159–64-5. Available from: http://www.sciencedirect.com/science/article/pii/S1550728908000130.

  52. Marszałek R, Ziemiański P, Łągiewska B, Pacholczyk M, Domienik-Karłowicz J, Trzebicki J, et al. The first Polish liver transplantation after Roux-en-Y gastric bypass surgery for morbid obesity: a case report and literature review. Ann Transplant [Internet]. 2015 Jan [cited 2015 Aug 5];20:112–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25711520.

  53. Campsen J, Zimmerman M, Shoen J, Wachs M, Bak T, Mandell MS, et al. Adjustable gastric banding in a morbidly obese patient during liver transplantation. Obes Surg [Internet]. 2008 [cited 2015 Aug 5];18(12):1625–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18704606.

  54. Heimbach JK, Watt KDS, Poterucha JJ, Ziller NF, Cecco SD, Charlton MR, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant [Internet]. 2013 Feb [cited 2015 Aug 5];13(2):363–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23137119.

  55. Nesher E, Mor E, Shlomai A, Naftaly-Cohen M, Yemini R, Yussim A, et al. Simultaneous liver transplantation and sleeve gastrectomy: prohibitive combination or a necessity? Springer US; 2017 May 9 [cited 2017 Jun 5];27(5):1387–90. Available from: http://link.springer.com/10.1007/s11695-017-2634-5.

  56. Lin MYC, Tavakol MM, Sarin A, Amirkiai SM, Rogers SJ, Carter JT, et al. Safety and feasibility of sleeve gastrectomy in morbidly obese patients following liver transplantation. Surg Endosc [Internet]. 2013 Jan [cited 2015 Aug 5];27(1):81–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22752278.

  57. Duchini A, Brunson ME. Roux-en-Y gastric bypass for recurrent nonalcoholic steatohepatitis in liver transplant recipients with morbid obesity. Transplantation [Internet]. 2001 Jul 15 [cited 2015 Aug 5];72(1):156–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11468551.

  58. Al-Nowaylati A-R, Al-Haddad BJS, Dorman RB, Alsaied OA, Lake JR, Chinnakotla S, et al. Gastric bypass after liver transplantation. Liver Transpl [Internet]. 2013 Dec [cited 2015 Aug 5];19(12):1324–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24039124.

  59. Ayloo S, Armstrong J, Hurton S, Molinari M. Obesity and liver transplantation. World J Transplant [Internet]. 2015 Sep 24 [cited 2017 Jun 5];5(3):95–101. Available from: http://www.wjgnet.com/2220-3230/full/v5/i3/95.htm.

  60. Lazzati A, Iannelli A, Schneck A-S, Nelson AC, Katsahian S, Gugenheim J, et al. Bariatric surgery and liver transplantation: a systematic review a new frontier for bariatric surgery. Obes Surg [Internet]. 2014 Jan 22 [cited 2017 Jun 5];25(1):134–42. Available from: http://link.springer.com/10.1007/s11695-014-1430-8.

  61. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  PubMed  Google Scholar 

  62. Sjöström L, Peltonen M, Jacobson P, Sjöström CD, Karason K, Wedel H, et al. Bariatric surgery and long-term cardiovascular events. JAMA [Internet]. 2012 Jan 4 [cited 2016 Jan 19];307(1):56–65. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22215166.

  63. Trastulli S, Desiderio J, Guarino S, Cirocchi R, Scalercio V, Noya G, et al. Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials. Surg Obes Relat Dis [Internet]. Jan [cited 2016 Jan 19];9(5):816–29. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23993246.

  64. Buchwald H, Estok R, Fahrbach K, Banel D, Sledge I. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery [Internet]. 2007 [cited 2017 Apr 13];142(4):621–35. Available from: http://www.sciencedirect.com/science/article/pii/S0039606007004928.

  65. Morino M, Toppino M, Forestieri P, Angrisani L, Allaix ME, Scopinaro N. Mortality after bariatric surgery. Ann Surg [Internet]. 2007 Dec [cited 2017 Apr 13];246(6):1002–9. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-200712000-00012.

  66. Puzziferri N, Roshek TB, Mayo HG, Gallagher R, Belle SH, Livingston EH. Long-term follow-up after bariatric surgery: a systematic review. JAMA [Internet]. American Medical Association; 2014 Sep 3 [cited 2015 Nov 30];312(9):934–42. Available from: http://jama.jamanetwork.com/article.aspx?articleid=1900516.

  67. Ladhani M, Craig JC, Irving M, Clayton PA, Wong G. Obesity and the risk of cardiovascular and all-cause mortality in chronic kidney disease: a systematic review and meta-analysis. Nephrol Dial Transplant [Internet]. 2016 May 4 [cited 2017 Apr 13];gfw075. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27190330.

  68. Millwala F, Nguyen GC, Thuluvath PJ. Outcomes of patients with cirrhosis undergoing non-hepatic surgery: risk assessment and management. World J Gastroenterol [Internet]. 2007 Aug 14 [cited 2015 Nov 10];13(30):4056–63. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4205305&tool=pmcentrez&rendertype=abstract.

  69. Jan A, Narwaria M, Mahawar KK. A systematic review of bariatric surgery in patients with liver cirrhosis. Obes Surg [Internet]. 2015 Aug [cited 2015 Nov 10];25(8):1518–26. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25982807.

  70. Brown RS. Live donors in liver transplantation. Gastroenterology [Internet]. 2008 May [cited 2017 Jan 24];134(6):1802–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18471556.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tomasz Dziodzio.

Ethics declarations

Disclosure

The authors did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval Statement

For this type of study, formal consent is not required.

Informed Consent Statement

Does not apply.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dziodzio, T., Biebl, M., Öllinger, R. et al. The Role of Bariatric Surgery in Abdominal Organ Transplantation—the Next Big Challenge?. OBES SURG 27, 2696–2706 (2017). https://doi.org/10.1007/s11695-017-2854-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-017-2854-8

Keywords

Navigation