Obesity has become one of the important factors affecting the entire management process of liver transplantation. Its impact is not only reflected in the increased risk of liver steatosis and ischemia-reperfusion injury in the donor, but also involves the increased technical difficulty during the perioperative period for the recipient, the increase in postoperative metabolic complications and poorer long-term prognosis. This article, based on recent relevant studies, reviews aspects such as the utilization of obese donors, the characteristics of adult and pediatric recipients, pre-transplant risk assessment and weight loss intervention, and post-transplant weight and metabolic management. Current evidence suggests that simply judging transplantation risks based on body mass index has limitations. Analysis of body composition, assessment of cardiovascular function and identification of sarcopenic obesity are more clinically valuable. For obese liver transplant recipients, in a multidisciplinary collaboration framework, emphasis should be placed on individualized screening, perioperative optimization and long-term follow-up management to improve the outcomes of the graft and the recipient.

Objective To study the regeneration regularity of neuropeptide Y positive(NPY+) nerves in splenic autotransplantation. Methods Healthy Wistar rats were randomly divided into two groups:(1)splenectomy and splenic autotransplantation group;(2) sham-operation group. Regeneration process and density changes of the NPY+ nerve fibers in the two groups were studied by immunohistochemical methods and computer image analysis qualification on day 7, 14, 30, 60, 90, 120 and 180 postoperatively. Results The NPY+ nerve fibers had no regeneration on day 30 postoperatively, but on day 60 nerve fibers appeared in the peri-region of the autotransplanted spleen, on day 90 nerve fibers extended into the inner-part of splenic autotransplants. Density of the nerve fibers gradually became greater and almost normal on 180 days after operation. Conclusions After splenic autotransplantation, the NPY+ nerve fibers could be regeneration in the autotransplants tissue. The renascent nerve fibers came from greater omentum which wrapes the splenic autografts.