Copyright ©The Author(s) 2018.
World J Gastroenterol. Aug 14, 2018; 24(30): 3330-3346
Published online Aug 14, 2018. doi: 10.3748/wjg.v24.i30.3330
Table 1 Impact of obesity on liver pathophysiology
Hepatic steatosis[9]Increased1
Liver primary tumors (as hepatocarcinoma)[2-4]Increased2
Chronic hepatitis C progression[12]Increased
Decompensation of cirrhotic patients[13,14]Increased
Portal hypertension[13,14]Increased
3Risk of post-operative complications after LT[15-17]Increased
Table 2 Nutritional recommendations for cirrhotic patients with obesity
1Daily energy intake[117]25-35 kcal/(kg•d) in patients with BMI 30-40 kg/m2 20-25 kcal/(kg•d) in patients with BMI > 40 kg/m2
2Protein intake[119]1.2-1.5 g/(kg•d)
3MicronutrientsIdentify and correct micronutrient deficiencies
Fiber25-45 g/d
Table 3 Main factors involved in the choice of the bariatric procedure in the setting of liver transplantation
Factors to considerSGRYGB
Bleeding risk of bleeding1IncreasedLow
Endoscopic access to the biliary treeConservedImpossible
Risk of portal vein thrombosisIncreasedNot affected
Risk of bariatric surgery induced liver failureAbsentLow
Absorption of immunosuppressive drugsPoorly affectedDecreased
Etiology of liver cirrhosis (NASH vs others)EffectiveVery Effective