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Czarnecka K, Czarnecka P, Tronina O, et al. Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation. Immun Inflamm Dis. 2021;10(1):3-21doi: 10.1002/iid3.538.
Czarnecka, K., Czarnecka, P., Tronina, O., Bączkowska, T., & Durlik, M. (2022). Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation. Immunity, inflammation and disease, 10(1), 3-21. https://doi.org/10.1002/iid3.538
Czarnecka, Kinga, et al. "Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation." Immunity, inflammation and disease vol. 10,1 (2022): 3-21. doi: https://doi.org/10.1002/iid3.538
Czarnecka K, Czarnecka P, Tronina O, Bączkowska T, Durlik M. Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation. Immun Inflamm Dis. 2022 Jan;10(1):3-21. doi: 10.1002/iid3.538. Epub 2021 Oct 01. PMID: 34598315.
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Immun Inflamm Dis. 2022 Jan;10(1):3-21. doi: 10.1002/iid3.538. Epub 2021 Oct 01.

Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation.

Immunity, inflammation and disease

Kinga Czarnecka, Paulina Czarnecka, Olga Tronina, Teresa Bączkowska, Magdalena Durlik

Affiliations

  1. Department of Transplant Medicine, Nephrology and Internal Diseases, Medical University of Warsa, Warsaw, Poland.

PMID: 34598315 DOI: 10.1002/iid3.538

Abstract

The obesity pandemic has resulted in an increasing demand for liver transplantation and has significantly altered the profile of liver transplant candidates in addition to affecting posttransplantation outcomes. In this review, we discuss a broad range of clinical approaches that warrant attention to provide comprehensive and patient-centred medical care to liver transplant recipients, and to be prepared to confront the rapidly changing clinical challenges and ensuing dilemmas. Adipose tissue is a complex and metabolically active organ. Visceral fat deposition is a key predictor of overall obesity-related morbidity and mortality. Limited pharmacological options are available for the treatment of obesity in the liver transplant population. Bariatric surgery may be an alternative in eligible patients. The rapidly increasing prevalence of nonalcoholic fatty liver disease (NAFLD) is a global concern; NAFLD affects both pre- and posttransplantation outcomes. Numerous studies have investigated pharmacological and nonpharmacological management of NAFLD and some of these have shown promising results. Liver transplant recipients are constantly exposed to numerous factors that result in intestinal microbiota alterations, which were linked to the development of obesity, diabetes type 2, metabolic syndrome (MS), NAFLD, and hepatocellular cancer. Microbiota modifications with probiotics and prebiotics bring gratifying results in the management of metabolic complications. Fecal microbiota transplantation (FMT) is successfully performed in many medical indications. However, the safety and efficacy profiles of FMT in immunocompromised patients remain unclear. Obesity together with immunosuppressive treatment, may affect the pharmacokinetic and/or pharmacodynamic properties of coadministered medications. Individualized immunosuppressive regimens are recommended following liver transplantation to address possible metabolic concerns. Effective and comprehensive management of metabolic complications is shown to yield multiple beneficial results in the liver transplant population and may bring gratifying results in improving long-term survival rates.

© 2021 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.

Keywords: gastrointestinal microbiome; liver transplant; metabolic syndrome; nonalcoholic fatty liver disease; obesity management; visceral obesity

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