The Impact of Metabolic Health and Obesity on Liver Transplant Candidates and Recipients.
Alexander S VogelRebecca RoedigerDagny von AhrensBrett E FortuneJonathan M SchwartzShalom FragerKristina R ChackoClara Y TowPublished in: Life (Basel, Switzerland) (2024)
Poor metabolic health and obesity have significant impacts on the outcomes of patients suffering from chronic liver disease, particularly those with metabolic dysfunction-associated steatotic liver disease. Patients with such comorbidities who require liver transplant evaluation for advancing liver disease or liver failure require special consideration due to increased risk of cardiovascular disease, renal dysfunction, sarcopenic obesity, and cancer. Those who have had a history of prior bariatric surgery pose specific anatomical constraints and may also be at increased risk of alcohol use disorder. Pre-operative risk assessment as well as strict control of metabolic risk factors are essential to reduce intra-operative and post-liver transplant complications. As immunosuppressive therapy exacerbates metabolic dysfunction and risk for cancer, post-liver transplant care must focus on balancing the need to prevent rejection and the impact of progressive metabolic dysfunction in this unique, but growing, patient population.
Keyphrases
- weight loss
- bariatric surgery
- cardiovascular disease
- risk factors
- metabolic syndrome
- risk assessment
- healthcare
- insulin resistance
- type diabetes
- oxidative stress
- public health
- liver failure
- papillary thyroid
- high fat diet induced
- adipose tissue
- stem cells
- newly diagnosed
- heavy metals
- mesenchymal stem cells
- human health
- physical activity
- obese patients
- chronic kidney disease
- lymph node metastasis
- replacement therapy
- cardiovascular risk factors