Obesity Management in Liver Transplantation
Summary
Obesity has emerged as a pivotal factor influencing both the candidacy for and outcomes of liver transplantation. Rising rates of obesity and its hepatic manifestation, non-alcoholic fatty liver disease, have made metabolic indications among the fastest growing reasons for transplant referral. Pre-transplant assessment must balance the risks of cardiovascular and respiratory complications against the potential benefits of transplantation. Nutritional evaluation and optimisation are crucial before surgery, aiming to reduce body mass index without exacerbating sarcopenia or frailty. Intra-operative and early post-operative care require tailored strategies to mitigate infectious and wound-healing complications that may be amplified in obese recipients. Long-term management focuses on preventing weight regain, monitoring graft function and minimising immunosuppressive regimens that promote metabolic derangement. Lifestyle interventions, structured exercise and nutritional counselling form the backbone of non-surgical weight management, while bariatric procedures are increasingly considered as adjuncts either before or after transplantation. A multidisciplinary approach ensures that candidate selection, perioperative care and chronic follow-up address both graft survival and global cardiometabolic health.
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Obesity Management in Liver Transplantation publication trend
The graph below shows the total number of articles in obesity management in liver transplantation across all publications each year (not limited to Nature Index journals).
Technical terms
Body mass index (BMI): A numerical value of weight in kilograms divided by the square of height in metres, used to classify underweight, normal weight, overweight and obesity.
Non-alcoholic fatty liver disease (NAFLD): A spectrum of liver disorders characterised by excessive fat accumulation in hepatocytes in the absence of significant alcohol intake.
Sarcopenia: Progressive and generalised loss of skeletal muscle mass and strength, often exacerbated by chronic disease and immobility.
Bariatric surgery: Surgical procedures designed to induce weight loss through restriction of food intake, malabsorption or hormonal modulation.
References
- From Listing to Recovery: A Review of Nutritional Status Assessment and Management in Liver Transplant Patients. Nutrients (2023).
- The Impact of Bariatric-Surgery-Induced Weight Loss on Patients Undergoing Liver Transplant: A Focus on Metabolism, Pathophysiological Changes, and Outcome in Obese Patients Suffering NAFLD-Related Cirrhosis. Journal of Clinical Medicine (2022).
- Increasing prevalence of obesity and diabetes among patients evaluated for liver transplantation in a Swiss tertiary referral center: a 10-year retrospective analysis. Swiss Medical Weekly (2022).
- Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain. Transplantation Direct (2022).
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