Successful Living Donor Liver Transplant Following Roux-en-Y Gastric Bypass in a Patient With Super Obesity With Hepatitis B Virus-Related Cirrhosis: A 7-Year Follow-Up Case Report.

Living donor liver transplant remains the only viable treatment for some patients with cirrhosis in countries with low deceased donor organ donation rates. However, morbid obesity limits the feasibility of living donor liver transplant because of increased perioperative risks and poor graft -to -recipient weight ratios. This report presents a case of living donor liver transplant following Roux -en -Y gastric bypass in a patient with super obesity (ie, body mass index ≥50, measured as kilograms per meter squared ) with hepatitis B virus -related cirrhosis. A 44 -year -old female with a body mass index of 54.5 (130 kg ) was diagnosed with hepatitis B virus -related cirrhosis. Despite 1 year on the transplant wait list and supervised weight loss efforts, her body mass index increased to 56. Laparoscopic Roux -en -Y gastric bypass was performed. One year after surgery, her weight reduced to 78 kg (body mass index 34.2 ), enabling a right lobe living donor liver transplant from her 24 -year -old son. Postoperative recovery was uneventful, and 7 years after transplant, the patient remains healthy, with no graft rejection or hepatitis B virus recurrence. Roux -en -Y gastric bypass may serve as a feasible bridge to living donor liver transplant in patients with super obesity and compensated cirrhosis, especially in regions with limited deceased donation.