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Reducing the load: The evolution and management of obesity and nonalcoholic steatohepatitis before liver transplantation
Author(s) -
Watt Kymberly D.
Publication year - 2012
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.23515
Subject(s) - nonalcoholic steatohepatitis , medicine , liver transplantation , steatohepatitis , obesity , gastroenterology , transplantation , intensive care medicine , nonalcoholic fatty liver disease , fatty liver , disease
Key Points 1. Obesity is common in patients with end‐stage liver disease of any cause. 2. Obesity is associated with comorbidities that can affect liver transplant candidacy, such as metabolic syndrome (diabetes, hyperlipidemia, and hypertension), cardiovascular disease, pulmonary disorders (related to obstructive sleep apnea), renal dysfunction, and malignancies. 3. Nonalcoholic steatohepatitis is the only indication for transplantation that is increasing in frequency, and it may soon become the leading indication. 4. There is no set body mass index above which liver transplantation is contraindicated. Transplant candidacy and outcomes depend on the cumulative comorbidities of the individual patient. 5. Weight loss is an important component of metabolic syndrome management and is recommended before liver transplantation. 6. Bariatric surgery may be considered in carefully selected patients with well‐compensated cirrhosis but is not recommended in patients with decompensated cirrhosis. Liver Transpl 18:S‐S, 2012. © 2012 AASLD.