Bariatric surgery is associated with an increased risk of alcohol use disorder and little empirical data exists regarding who develops alcoholic liver disease (ALD) and ultimately requires liver transplantation. Understanding which patients are at highest risk may inform clinical practice and help reduce alcohol-related complications post-bariatric surgery.


Data was abstracted from a large healthcare system with bariatric surgery and liver transplantation programs. There were 405 adults (Mage = 55.6 ± 7.7, 19% female) who underwent liver transplantation for ALD between 1/1/1999 and 3/1/2019. Results compared using Wilcoxon rank sum and Fisher’s exact tests. Additional medical and psychological data will be obtained via chart review prior to presentation.


Of this sample, 5 (1.23%) required ALD liver transplantation following Roux-en-Y gastric bypass (RYGB; Mage = 42.7 ± 9.3, 80% female). The average time between RYGB and transplantation was 10.3 years (SD = 4.8). When compared to the larger transplantation population (n = 400), those with a history of RYGB were significantly younger (p = .003), included more women (p = .005) and had significantly higher model for end-stage liver disease (MELD) scores at time of transplant (M = 28.0 ± 5.5 vs. 20.2 ± 8.4, p = .045).


Individuals with a history of bariatric surgery who subsequently require ALD liver transplantation are significantly younger, disproportionately female, and are more medically ill when compared to other transplant recipients with ALD. Additional research is needed to better understand the risk for severe alcohol use disorder and ALD following bariatric surgery.