Santo Domingo.— A study by the prestigious Mayo Clinic has revealed that performing bariatric surgery simultaneously with a liver transplant in patients with severe obesity is not only safe, but also leads to significant long-term health improvements.
Published in the journal Journal of Hepatology, the study analyzed for a decade the cases of patients undergoing only liver transplantation and compared them with those who received both procedures in the same surgical act. The results indicate that those who opted for the combined approach experienced sustained weight loss, as well as a lower incidence of type 2 diabetes and a reduction in the risk of recurrence of fatty liver disease.
Dr. Julie Heimbach, director of the Mayo Clinic Transplant Center in Minnesota and lead author of the study, stated that this strategy represents a transformation in the management of patients with liver disease and morbid obesity.
“Estamos viendo cambios notables en la salud de los pacientes. Esta combinación no solo previene la vuelta de la enfermedad que afectó el hígado, sino que además reduce riesgos asociados a la obesidad como enfermedades cardiovasculares y cáncer”, explicó.
Currently, more than 41% of candidates for liver transplant in the U.S. are obese, which in many cases prevents their eligibility to receive a new organ. Obesity significantly contributes to the appearance of MASLD (metabolic dysfunction-associated steatotic liver disease), formerly known as non-alcoholic fatty liver disease, a condition that can evolve into cirrhosis and liver failure.
Dr. Todd Kellogg, a bariatric surgeon at Mayo Clinic and co-author of the study, emphasized the medical logic of this approach: “It makes a lot of sense to protect the new liver from the same damage that led to the transplant. By performing both surgeries together and safely, we increase the chances of success and longevity of the graft.”
Although new weight loss drugs, such as GLP-1 agonists, are being used successfully in some patients before and after transplantation, specialists insist that bariatric surgery remains a more effective and lasting alternative for those suffering from extreme obesity.
“The reality is that many of these patients require a more forceful intervention than what current medications can offer,” explained Dr. Heimbach. “Bariatric surgery not only reduces weight, but also improves metabolic conditions in a more sustained way.”
La clave del éxito, coinciden los autores, ha sido el trabajo en equipo. “Este tipo de pacientes requiere más que un trasplante,” apuntó el Dr. Ty Diwan, cirujano de trasplantes y también coautor del estudio.
“El enfoque multidisciplinario, que combina hepatología, cirugía bariátrica, endocrinología y nutrición, marca la diferencia en la calidad de vida del paciente”.
This study sets an important precedent and opens the door to new clinical practices to improve the survival and quality of life of those who simultaneously face severe obesity and advanced liver disease.
