Obesity and liver transplant

Mayo Clinic doctors have experience treating obese people who have liver failure and many related conditions they may experience. Many people who need a liver transplant may be obese.

In highly selected cases, surgeons may do a liver transplant and a sleeve gastrectomy, a type of bariatric surgery, at the same time for obese people who are eligible. This additional bariatric surgery may prevent recurrent obesity and failure of the newly transplanted liver. Researchers study the potential benefits and complications of bariatric surgery for people before, during or after liver transplant.

Researchers also study the effects of obesity and related conditions before and after liver transplant. Several complications can occur after transplant due to obesity.

Some immunosuppressive medication side effects, such as high blood pressure and insulin resistance, may lead to metabolic syndrome and other problems after your liver transplant. Metabolic syndrome is associated with obesity and other serious conditions, including heart and blood vessel conditions (cardiovascular diseases) and liver organ (graft) failure. Doctors may evaluate you for metabolic syndrome in order to appropriately treat your condition, which may include changing certain medications and other therapies.

Some people who are overweight or obese may develop nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH), a more serious form of NAFLD. In NAFLD, fat accumulates in your liver and causes liver complications. This condition may occur before or after a liver transplant. Doctors may test a very small sample of your liver tissue (liver biopsy) at follow-up appointments after your transplant to diagnose these conditions and determine the most appropriate treatments.