Baggio L, Gianni S, De Carlis R, Valsecchi MAM, Barbaglio C, Brunetti A, Perricone G, Lauterio A, Monti G. Letter to the Editor: Three questions to be answered when evaluating a super obese patient for urgent liver transplant. World J Transplant 2026; 16(2): 115352 [DOI: 10.5500/wjt.v16.i2.115352]
Corresponding Author of This Article
Leonardo Baggio, MD, Department of Medicine and Surgery, Università di Milano Bicocca, Via Podgora 23, Monza 20900, Lombardy, Italy. l.baggio6@campus.unimib.it
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Transplantation
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letter
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Baggio L, Gianni S, De Carlis R, Valsecchi MAM, Barbaglio C, Brunetti A, Perricone G, Lauterio A, Monti G. Letter to the Editor: Three questions to be answered when evaluating a super obese patient for urgent liver transplant. World J Transplant 2026; 16(2): 115352 [DOI: 10.5500/wjt.v16.i2.115352]
World J Transplant. Jun 18, 2026; 16(2): 115352 Published online Jun 18, 2026. doi: 10.5500/wjt.v16.i2.115352
Letter to the Editor: Three questions to be answered when evaluating a super obese patient for urgent liver transplant
Leonardo Baggio, Stefano Gianni, Riccardo De Carlis, Mila Angela Maria Valsecchi, Caterina Barbaglio, Andrea Brunetti, Giovanni Perricone, Andrea Lauterio, Gianpaola Monti
Leonardo Baggio, Department of Medicine and Surgery, Università di Milano Bicocca, Monza 20900, Lombardy, Italy
Stefano Gianni, Mila Angela Maria Valsecchi, Caterina Barbaglio, Andrea Brunetti, Gianpaola Monti, Department of Anesthesia and Intensive Care Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan 20162, Lombardy, Italy
Riccardo De Carlis, Andrea Lauterio, Department of General Surgery and Transplantation, ASST Grande Ospedale Metropolitano Niguarda, Milan 20162, Lombardy, Italy
Giovanni Perricone, Hepatology and Gastroenterology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan 20162, Lombardy, Italy
Co-first authors: Leonardo Baggio and Stefano Gianni.
Author contributions: Baggio L and Gianni S performed conceptualization, investigation, writing – original draft, writing – review & editing; De Carlis R performed formal analysis, methodology, supervision, validation; Valsecchi MAM, Perricone G, Lauterio A, and Monti G performed supervision, validation; Barbaglio C and Brunetti A performed data curation, supervision.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Leonardo Baggio, MD, Department of Medicine and Surgery, Università di Milano Bicocca, Via Podgora 23, Monza 20900, Lombardy, Italy. l.baggio6@campus.unimib.it
Received: October 24, 2025 Revised: November 19, 2025 Accepted: January 19, 2026 Published online: June 18, 2026 Processing time: 218 Days and 15.8 Hours
Abstract
We read with interest the study by Cigrowsky et al published in the World Journal of Transplantation. Obesity is a common and serious health issue worldwide. Its incidence has been rapidly and continuously increasing. Obesity causes extensive and heterogeneous comorbidities affecting nearly all organs, including the liver. Severe obesity (SO) has historically been considered a contraindication for liver transplantation due to the increased risk of perioperative complications, mortality, and graft failure. However, recent studies have shown that SO is not associated with worse post-transplant outcomes but rather with higher waiting list mortality. Therefore, severely obese patients should be considered potential candidates and, conversely, prioritized.
Core Tip: Perioperative management of super-obese patients eligible for liver transplantation (LT) remains an area with limited evidence and largely depends on the organizational policies of each transplant center. Each case of super-obese patients with severe liver disease undergoing LT is unique and deserves literature reporting to enhance the collective knowledge. Bariatric surgery may be considered before or after LT to improve outcomes in selected cases. This manuscript reports a series of dilemmas arising from the case of a super obese patient undergoing urgent LT.
