P1436 - Perioperative Outcomes of Liver Transplantation in Patients With Prior Bariatric Surgery: A Nationwide Analysis

Bhanu Siva Mohan Pinnam, MD¹, Daksh Ahluwalia, MD¹, Dushyant S. Dahiya, MD², Clive J. Miranda, DO, MSc³, Patricia Zarza-Gulino, MD¹, Sahib Singh, MD⁴, Sanket Basida, MD⁵, Chun-Wei Pan, MD¹, Hema S. Pinnam, ⁶, Harishankar Gopakumar, MD⁷, Ishan Vohra, MD⁸, Seema Gandhi, MD¹, Sumant Inamdar, MD^9
1John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ²The University of Kansas School of Medicine, Kansas City, KS; ³CHI Health Creighton University Medical Center, Omaha, NE; ⁴Sinai Hospital, Baltimore, MD; ⁵University of Missouri School of Medicine, Columbia, MO; ⁶Jagadguru Sri Shivarathreeshwara Medical College, Mysuru, Karnataka, India; ⁷University of Illinois College of Medicine, Bloomington, IL; ⁸University of Illinois College of Medicine, Peoria, IL; ⁹University of Arkansas for Medical Sciences, Little Rock, AR

Introduction: Bariatric surgery is instrumental in the management of severe obesity and its associated comorbidities. As the prevalence of obesity continues to rise, an increasing number of patients undergoing liver transplantation have a history of bariatric surgery. Understanding how prior bariatric surgery impacts hospitalization characteristics and outcomes in liver transplant patients is crucial for optimizing care and resource allocation. This study aims to compare peri-operative outcomes and healthcare utilization between liver transplant patients with and without a history of bariatric surgery.

Methods: The National Inpatient Sample 2016-2021 was utilized for this study. Using ICD-10 CM diagnostic and procedure codes, patients undergoing liver transplantation were identified, and divided into two cohorts – those with a prior history of bariatric surgery (BaS) and those without. Hospitalization characteristics and comorbidities were highlighted and compared. A regression analysis was performed to compare perioperative outcomes, while adjusting for potential confounders.

Results: 48,525 patients undergoing liver transplant including 550 patients with a prior history of bariatric surgery and 47,975 patients without prior bariatric surgery were identified during the study period. A larger proportion of patients in the BaS cohort were female (70% vs 37.19%, P< 0.001) and had protein-energy malnutrition (40% vs 29.34%, P=0.015). The distribution of other baseline characteristics including the Charlson comorbidity index, race, hospital region, insurance, and discharge disposition did not differ significantly between the two cohorts. The rates of inpatient mortality, ICU admission, liver transplant infection, post-operative cholangitis, respiratory failure, sepsis, acute kidney injury and venous thromboembolism were not statistically different, when adjusted for confounders. However, patients in the BaS cohort had a shorter mean length of hospital stay (18.29 days vs 21.29 days, difference on regression 4.46 days, P=0.007), and lower hospitalization charges (mean $564,268 vs $705,803, difference on regression $147,057, P=0.002).

Discussion: Patients with a history of prior bariatric surgery are not at a higher risk of perioperative adverse outcomes when undergoing liver transplant. These patients experience shorter hospital stays, and lower hospitalization charges, despite comparable complication rates. Further prospective studies are necessary to elucidate the reasons behind these findings.


Disclosures:


Bhanu Siva Mohan Pinnam, MD¹, Daksh Ahluwalia, MD¹, Dushyant S. Dahiya, MD², Clive J. Miranda, DO, MSc³, Patricia Zarza-Gulino, MD¹, Sahib Singh, MD⁴, Sanket Basida, MD⁵, Chun-Wei Pan, MD¹, Hema S. Pinnam, ⁶, Harishankar Gopakumar, MD⁷, Ishan Vohra, MD⁸, Seema Gandhi, MD¹, Sumant Inamdar, MD⁹. P1436 - Perioperative Outcomes of Liver Transplantation in Patients With Prior Bariatric Surgery: A Nationwide Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.