Optimizing liver transplant candidacy in patients with cirrhosis and obesity

The epidemic of obesity in the United States has led to a significant increase in the prevalence of obesity in the liver transplant population, with metabolic dysfunction-associated steatotic liver disease becoming one of the most common indications for liver transplantation. Despite this rise in obesity, the optimal management strategies in the pretransplant, peritransplant, and posttransplant phases of care have not yet been determined. In the current review, we will present and discuss the available evidence for the surgical management of obesity, including the optimal timing, as well as a review of the novel medical therapies and how these strategies may best be utilized to provide ideal long-term outcomes for liver transplant patients with obesity.