Adult- adult liver living donor after bariatric surgery. First report of 3 cases

Abstract

Presenter: Gabriela Ochoa MD | Pontificia Universidad Católica de Chile Background: The increasing prevalence of bariatric surgery and the use of living donors for liver transplantation, could potentially face us with donors with this surgical history. Due to association between obesity and non-alcoholic liver disease, we must beware of some level of liver damage. Furthermore, it's been demonstrated that bariatric surgery decreases NASH progression and reverts simple steatosis cases. We present 3 cases of patients with prior bariatric surgery, who were selected as donors in our Living Donor Liver Transplant (LDLT) program. Methods: Retrospective descriptive analysis of patients with previous bariatric surgery, who underwent right donor hepatectomy for LDLT at Pontifical Catholic University of Chile Clinical Hospital. The information was obtained from clinical reports and telephone interviews. Data analysis was made with descriptive statistic. Results: Case 1: 53 years-old male, who underwent laparoscopic sleeve gastrectomy (LSG) in 2013 for BMI 33,1. In 2016, before hepatectomy, his BMI was 21,5. Normal liver function tests. Case 2: 46 years-old female, she underwent LSG (2009) and conversion to gastric bypass (2011) for severe obesity, BMI max 39,7. In pre-transplant study to become a donor BMI was 35 (2016). Liver biopsy without steatosis and normal liver function tests. Case 3: 53 years-old female, LSG performed (2013), BMI max 31,5. Normal preoperative study with BMI 24,2 (2016). The three patients underwent successfully to right donor hepatectomy. No complications were observed and postoperative trend of liver function tests were in expected ranges. No transfusion requirements, mean operative time was 300 minutes (program average 325 min), hospital stay 6,3 days, with adequate liver function in the recipients. Conclusion: The three patients underwent successfully to right donor hepatectomy. No complications were observed and postoperative trend of liver function tests were in expected ranges. No transfusion requirements, mean operative time was 300 minutes (program average 325 min), hospital stay 6,3 days, with adequate liver function in the recipients.