{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:39:01Z","timestamp":1753879141271,"version":"3.41.2"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100011878","name":"Vlaamse regering","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011878","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Patients with a history of metabolic and bariatric surgery (MBS) are susceptible to developing alcohol use disorder. Outcome after transplantation for alcohol\u2010related liver disease (ALD) has not been studied in\u2010depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included adult patients who underwent a liver transplantation (LT) in Belgium between 1 January 2013 and 31 December 2022 for ALD. We captured all patients with a history of MBS prior to developing ALD, and included non\u2010MBS patients for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 39 patients who underwent MBS before developing ALD, and included 443 non\u2010MBS patients with an LT for ALD as controls. The median time between MBS and diagnosis of severe liver disease was 7.2\u2009years. MBS patients were 9\u2009years younger at the time of transplantation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Pre\u2010LT hepatocellular carcinoma was more prevalent in the non\u2010MBS group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), while severe bacterial infections occurred more frequently in those with prior MBS. Importantly, patients with MBS had a lower survival after LT in age\u2010 and sex\u2010adjusted Cox regression analysis (HR 2.205, <jats:italic>p<\/jats:italic>\u2009=\u20090.023). Liver disease was listed in 70.0% versus 13.3% of patients as the main cause of death. Liver\u2010related mortality was linked to alcohol use relapse post\u2010LT, with significantly more MBS patients experiencing relapse (30.8% vs. 13.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Following MBS, excessive alcohol use can progress to end\u2010stage ALD and need for LT. These patients present at a younger age, with more signs of hepatic decompensation, and can be at a higher risk for post\u2010LT mortality, especially liver\u2010related death.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.16219","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T16:20:50Z","timestamp":1734625250000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Clinical Relevance of Prior Metabolic and Bariatric Surgery in Alcohol\u2010Related Liver Disease in a Nationwide Belgian Liver Transplant Population"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5734-3467","authenticated-orcid":false,"given":"Sander","family":"Lefere","sequence":"first","affiliation":[{"name":"Hepatology Research Unit, Department of Internal Medicine and Pediatrics Ghent University  Ghent Belgium"},{"name":"Liver Research Center Ghent Ghent University, Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto Ivan","family":"Troisi","sequence":"additional","affiliation":[{"name":"Division of HBP, Minimally Invasive and Robotic Surgery, Transplantation Service Federico II University Hospital  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Karam","sequence":"additional","affiliation":[{"name":"European Society for Organ Transplantation  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantino","family":"Fondevila","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery Hospital Universitario La Paz, CiberEHD  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederik","family":"Nevens","sequence":"additional","affiliation":[{"name":"Department of Hepatology University Hospital Leuven  Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jef","family":"Verbeek","sequence":"additional","affiliation":[{"name":"Department of Hepatology University Hospital Leuven  Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Detry","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery and Transplantation, CHU Liege University of Liege  Liege Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Lanthier","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9pato\u2010gastroent\u00e9rologie Cliniques Universitaires Saint\u2010Luc, UCLouvain  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1471-8585","authenticated-orcid":false,"given":"Matteo","family":"Serenari","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary and Transplant Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4144-3652","authenticated-orcid":false,"given":"Leke","family":"Wiering","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0572-8741","authenticated-orcid":false,"given":"Thomas","family":"Vanwolleghem","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University Hospital Antwerp  Antwerp Belgium"},{"name":"Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics University of Antwerp  Antwerp Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB H\u00f4pital Erasme Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederik","family":"Berrevoet","sequence":"additional","affiliation":[{"name":"Department of General and Hepatobiliary Surgery and Liver Transplantation Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Geerts","sequence":"additional","affiliation":[{"name":"Hepatology Research Unit, Department of Internal Medicine and Pediatrics Ghent University  Ghent Belgium"},{"name":"Liver Research Center Ghent Ghent University, Ghent University Hospital  Ghent 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