Double Impact: Pioneering Simultaneous Liver Transplant and Gastric Sleeve

Liver failure associated with obesity is on the rise in the United States. Mayo Clinic transplant surgeon Julie K. Heimbach, M.D., and bariatric surgeon Todd A. Kellogg, M.D., discuss a pioneering technique combining liver transplant and gastric sleeve resection into one single surgery.

The combined procedure is serving a patient population with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis that had traditionally been left with few treatment options. At many other hospitals, these patients are turned away for transplant and asked to return when they lose weight. In other cases, the patient will receive a liver transplant but face the risk of short- and long-term complications due to their excess weight. If the liver transplant and gastric sleeve took place as two separate surgeries, the gastric sleeve surgery would be technically more demanding due to scar tissue from the liver transplant and immunosuppression medications. These reasons were the impetus behind Mayo Clinic’s innovative approach combining both operations.

Video Content Outline:

  • Introduction
  • Mayo Clinic’s surgical innovation for patients with obesity and liver failure (0:31)  
  • Results (1:02)
  • Challenges and risks to alternative approaches (1:18)
  • Benefits to combined approach (3:42)
    • Exposure for liver transplant and upper abdomen during surgery (3:43)
    • Benefit of gastric sleeve versus gastric bypass following liver transplant (4:00)
  • Conclusion (4:42)

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Mayo Clinic