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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 18, 2025; 15(4): 110957
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.110957
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.110957
Increased risk of rejection in liver transplant recipients with a history of malabsorptive bariatric surgery
Jaimie Chang, Stephanie Trautmann, Abbigale Hampton, Edie Chan, Nathalie Sela, Department of General Surgery, Rush University Medical Center, Chicago, IL 60612, United States
Author contributions: Chang J and Trautmann S wrote the original draft; Chang J and Hampton A participated in the formal analysis and investigation; Chang J and Chan E were responsible for developing the methodology; Chang J, Chan E and Sela N designed the study; Chang J, Trautmann S, Hampton A, Chan E, and Sela N participated in the review and editing, read and approved the final version of the manuscript to be published.
Institutional review board statement: This study was submitted to The Institutional Review Board at Rush Systems for Health and was determined to be exempt from Institutional Review Board Review (No. 24092301-IRB01) under 45 CFR 46.104(d)(4). Waiver of Health Insurance Portability and Accountability Act authorization for secondary analysis of data chart review was granted under 45 CFR 164.512(i)(2)(ii).
Informed consent statement: Conduct of the study complied with the Institutional Review Board exemption determination and all applicable regulations.
Conflict-of-interest statement: All authors report no conflicts of interest relevant to the content of this study.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data is available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jaimie Chang, MD, Researcher, Department of General Surgery, Rush University Medical Center, 1750 West Harrison Street, Jelke Suite 769, Chicago, IL 60612, United States. jaimie_chang@rush.edu
Received: June 19, 2025
Revised: July 28, 2025
Accepted: September 19, 2025
Published online: December 18, 2025
Processing time: 153 Days and 10.3 Hours
Revised: July 28, 2025
Accepted: September 19, 2025
Published online: December 18, 2025
Processing time: 153 Days and 10.3 Hours
Core Tip
Core Tip: This study compares perioperative outcomes and episodes of acute cellular rejection between liver transplant recipients with a history of malabsorptive bariatric surgery and controls. Patients with malabsorptive anatomy have higher rates, frequency, and earlier rejection, but no differences in perioperative or 1 year survival outcomes. The mechanism of increased acute cellular rejection is unknown but may be due to altered drug absorption following intestinal bypass. Therefore, this cohort may require meticulous drug-level monitoring or specified postoperative protocols to reduce rejection risk.