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Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation.
Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time... read more

Published: 2015-02-25

The First Polish Liver Transplantation after Roux-en-Y Gastric Bypass Surgery for Morbid Obesity: A Case Report and Literature Review

Rafał Marszałek, Paweł Ziemiański, Beata Łągiewska, Marek Pacholczyk, Justyna Domienik-Karłowicz, Janusz Trzebicki, Zbigniew Wierzbicki, Krzysztof Jankowski, Maciej Kosieradzki, Dariusz Wasiak, Maurycy Jonas, Piotr Pruszczyk, Magdalena Durlik, Wojciech Lisik, Andrzej Chmura

(Department of General Surgery and Transplantology, Transplantation Institute, Medical University of Warsaw, Warsaw, Poland)

Ann Transplant 2015; 20:112-115

DOI: 10.12659/AOT.893797

BACKGROUND: Morbid obesity is associated with liver pathology, most commonly non-alcoholic steatohepatitis (NASH) leading to cirrhosis. However, the morbid obesity impedes qualification for organ transplantation.
CASE REPORT: We present a case report of a 56-year-old woman who underwent bariatric procedure followed by liver transplantation (LTx). Her initial weight was 130.2 kg (BMI 50.9 kg/m2). The patient had a history of arterial hypertension, diabetes, gonarthrosis, and obstructive sleep apnea syndrome and no history of alcohol abuse. She underwent Roux-en-Y gastric bypass (RYGB) procedure. The routine intraoperative liver biopsy revealed fibrosis (III°), steatosis (II°), and intra-acinar inflammation. The operation led to a substantial loss of weight. Two years after the surgery the patient was referred to the Transplantation Clinic of Department of General Surgery and Transplantology with suspicion of liver failure due to advanced cirrhosis, which could be a result of previously diagnosed NASH and, probably, excessive alcohol use after bariatric surgery. The patient was qualified for elective LTx, which was performed 3 years after the RYGB. Immediately before LTx, the patient’s weight was 65 kg (BMI 25.4 kg/m2). The postoperative period was complicated by bleeding into the peritoneal cavity, which required reoperation. She also had renal failure, requiring renal replacement therapy. One year after LTx, she showed stable liver function with normal transaminases activity and bilirubin concentration, remission of diabetes, and good renal function.
CONCLUSIONS: Steatohepatitis in morbidly obese patients may lead to cirrhosis. Bar... read more

Keywords: Bariatric Surgery, Fatty Liver, Liver Transplantation, Obesity

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