Nutritional issues in patients with obesity and cirrhosis

Table 3 Main factors involved in the choice of the bariatric procedure in the setting of liver transplantation

Factors to consider	SG	RYGB
Bleeding risk of bleeding1	Increased	Low
Endoscopic access to the biliary tree	Conserved	Impossible
Risk of portal vein thrombosis	Increased	Not affected
Risk of bariatric surgery induced liver failure	Absent	Low
Absorption of immunosuppressive drugs	Poorly affected	Decreased
Etiology of liver cirrhosis (NASH vs others)	Effective	Very Effective

¹Consider measuring of portal pressure and use of transjugular intrahepatic portosystemic shunt in case of bariatric surgery before liver transplantation. SG: Sleeve gastrectomy; RYGP: Roux-en-Y gastric bypass; NASH: Non-alcoholic steato hepatitis.