Bariatric Surgery Patients Are at Risk for Alcoholic Liver Disease with Need for Liver Transplantation
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Bariatric Surgery Patients Are at Risk for Alcoholic Liver Disease with Need for Liver Transplantation Sander Lefere 1 & Lenka Stroobant 1 & Xavier Verhelst 1 & Aude Vanlander 2 & Frederik Berrevoet 2 & Roberto Ivan Troisi 2,3 & Yves Van Nieuwenhove 4 & Xavier Rogiers 2 & Hans Van Vlierberghe 1 & Anja Geerts 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Recent studies have indicated that patients with prior bariatric surgery (BS) are at risk for developing alcohol use disorder. We explored patient demographics and impact on liver disease severity in 11 patients with prior BS listed for transplantation due to alcoholic liver disease, and compared these with 177 patients without BS. BS patients were younger with a female predominance and presented with more severe decompensation. The timeframe between diagnosis, listing, and transplantation was significantly shorter in patients with prior BS. The incidence of post-transplant complications and 3-year survival rate was comparable. In conclusion, alcoholic liver disease with rapid decompensation may develop after BS, warranting rapid identification with referral to a transplant center. Attention should be paid to pre-surgery screening for alcohol overuse risk factors. Keywords Alcohol use disorder . RYGB . HCC . Decompensated cirrhosis
Introduction Alcohol use disorder (AUD) is a leading cause of disease, and alcoholic liver disease (ALD) is among the three main indications for liver transplantation (LT) in Europe and the USA,
where the number of patients listed for ALD has continued to rise over the last decade [1–3]. Multiple recent studies have indicated that patients who underwent bariatric surgery (BS) are at increased risk for AUD [4, 5], depending on the type of weight loss surgery
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04806-8) contains supplementary material, which is available to authorized users. * Sander Lefere [email protected]
Xavier Rogiers [email protected] Hans Van Vlierberghe [email protected]
Lenka Stroobant [email protected]
Anja Geerts [email protected]
Xavier Verhelst [email protected] 1
Department of Gastroenterology and Hepatology, Hepatology Research Unit, Ghent University, 1K12IE, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
2
Department of General and Hepatobiliary Surgery, Liver Transplantation Service, Ghent University, Ghent, Belgium
Roberto Ivan Troisi [email protected]
3
Department of Clinical Medicine and Surgery, Federico II University Naples, Naples, Italy
Yves Van Nieuwenhove [email protected]
4
Department of Gastrointestinal Surgery, Ghent University, Ghent, Belgium
Aude Vanlander [email protected] Frederik Berrevoet [email protected]
OBES SURG
performed [6]. In a large prospective cohort study, the cumulative incidence of AUD 5 years after Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) was 20% an
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