Liver failure and transplantation after duodenal switch

Liver failure (LF) and liver transplant (LT) are rare after a biliopancreatic diversion/duodenal switch procedure for obesity, but occasionally it may happen. Two clinical cases are presented. One patient, 18 years ago, had LF, but a liver donor could not be found, and the patient died. The second patient, 2 years ago, received a successful LT and is now well and asymptomatic. Careful follow-up, medical management and surgical intervention may prevent the occurrence of LF. Transplantation and bowel reversal may be necessary.