Sleeve Gastrectomy in Non-alcoholic Steatohepatitis (NASH) and Liver Cirrhosis

Non-Alcoholic Fatty Liver Disease (NAFLD) is a clinic-histopathological spectrum that results from fat accumulation in hepatocytes, that can be present without inflammatory changes (hepatic steatosis) or with concomitant inflammation (steatohepatitis), resulting in the condition called Non-Alcoholic Steatohepatitis (NASH). The prevalence of NAFLD is alarmingly increasing worldwide, not only in adults, where it is reported to be between 6 and 35%, but also in children and adolescents with the prevalence ranging from 0.7% for ages 2–4 and up to 17.3% for ages 15–19 years. In this chapter we will discuss the implications that NASH and NAFLD have on the performance of sleeve gastrectomy, as well as techniques and scoring systems for diagnosing these conditions. We also look into sleeve gastrectomy in transplant patients in detail, providing the most prominent recommendations.