Liver Transplantation in a Case of Steatohepatitis and Subacute Hepatic Failure after Biliopancreatic Diversion for Morbid Obesity

Background: Biliopancreatic diversion (BPD) was designed to avoid the serious complications of jejunoileal bypass (steatohepatitis and hepatic failure). Although this is today considered a safe and effective procedure, a few reports of patients who developed steatohepatitis and subsequently died in hepatic failure exist. Methods: We report a morbidly obese patient who developed subacute hepatitis resulting in hepatic failure 1 year after BPD. Results: Because of irreversible liver failure the decision to perform a liver transplantation was made.The patient underwent emergency liver transplant and lengthening of the common limb. The course of liver transplantation and the patient's recovery were uneventful. Conclusion: Severe liver disease may rarely follow BPD. Liver transplantation and lengthening of the common bowel may be performed to treat these patients.