Bariatric surgery and long-term outcomes.

We appreciate the interest in our work by Professor Yildiz looking at the association between bariatric surgery and outcomes among patients evaluated for liver transplantation.(1) We share the sentiment that some of the outcomes noted in the study may be related to malabsorptive rather than restrictive weight reduction surgery. As reflected in the results, rates of delisting or death were high for gastric bypass versus non-gastric bypass patients (44% vs. 16.7%, p<0.01). However, rates of moderate or severe malnutrition were similar between the groups (68% vs. 57%, p=0.5). Hence, in this analysis of historical data it is hard to assess whether it is the surgery itself of consequence of malnutrition regardless of surgery type that are driving the effect. This article is protected by copyright. All rights reserved.