Background Knowledge regarding the feasibility and safety
of sleeve gastrectomy (SG) in obese liver transplant recipients
is scarce. We report our experience of sleeve gastrectomy
following liver transplantation (LT).
Methods All patients who had undergone LT and subsequently
underwent SG at our institution were retrospectively
reviewed. Surgical outcomes, liver and kidney function tests,
outcomes of obesity-related comorbidities, and excess weight
loss were analyzed.
Results Between May 2008 and February 2015, six consecutive
patients underwent SG after LT. Three procedures (50%)
were performed totally by laparoscopy, and three by upfront
laparotomy for concomitant incisional hernia complex repair.
Within the first 30 days, one complication occurred: early
gastric fistula that required multiple endoscopic procedures
and re-intervention, followed by death 19 months after SG
due to multi-organ failure. Another patient had one late complication:
chronic infection on a parietal mesh successfully
controlled by mesh removal. Excess weight loss averaged
76% at 2 years with a median BMI of 28 (21–39) kg/m2
.
Median follow-up was 37.2 months (range 13–101 months).
Median length of stay was 9 days (range: 6–81 days).
Conclusions SG is technically feasible after LT and resulted in
weight loss without adversely affecting graft function and immunosuppression.
However, morbidity and mortality are
high.

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• Sleeve Gastrectomy After Liver Transplantation: Feasibility and Outcomes