Obesity is a frequent complication following liver transplantation and is insufficiently responsive to dietary and life style advice. We studied the safety of orlistat treatment in obese and overweight liver transplant recipients (n = 15) on a stable tacrolimus-based immunosuppressive regimen. For safety reasons, the treatment period was restricted (6 months 120 mg t.i.d., 3 months 120 mg daily). Three patients dropped out, tacrolimus dose was adjusted in six of 12 remaining patients (dose reduction in 4, increase in 2, P = N.S.). All dose adjustments occurred during the 6 months of orlistat 120 mg t.i.d. therapy. No drug intolerance, adverse events or episodes of rejection occurred during the study. Efficacy of orlistat treatment in this population could not be shown, because a formal control population was not included in this safety trial. Moreover, only a significant decrease of waist circumference (P < 0.01 versus start of the study), but not of weight or body mass index, was achieved in the treated group. Orlistat treatment is well tolerated in liver transplant recipients and can be started safely, provided immunosuppressive drug levels and dietary adherence are closely monitored.
Sjöström Lars, Rissanen Aila, Andersen Teis, Boldrin Mark, Golay Alain, Koppeschaar Hans PF, Krempf Michel, Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients, 10.1016/s0140-6736(97)11509-4
Davidson Michael H., Hauptman Jonathan, DiGirolamo Mario, Foreyt John P., Halsted Charles H., Heber David, Heimburger Douglas C., Lucas Charles P., Robbins David C., Chung Jain, Heymsfield Steven B., Weight Control and Risk Factor Reduction in Obese Subjects Treated for 2 Years With Orlistat : A Randomized Controlled Trial, 10.1001/jama.281.3.235
Zhi J, J Clin Pharmacol, 42, 1011 (2002)
??sberg Anders, Interactions Between Cyclosporin and Lipid-Lowering Drugs : Implications for Organ Transplant Recipients, 10.2165/00003495-200363040-00003
Cailotto C, Eur J Neurosci, 22, 2531 (2005)
Errasti P, Garcı́a I, Lavilla J, Ballester B, Manrique J, Purroy A, Reduction in blood cyclosporine concentration by Orlistat in two renal transplant patients, 10.1016/s0041-1345(01)02829-9
Nägele H., Petersen B., Bonacker U., Rödiger W., Effect of orlistat on blood cyclosporin concentration in an obese heart transplant patient, 10.1007/s002280050690
Kim DH, Taehan Kan Hakhoe Chi, 8, 317 (2002)
Lau G, Med Sci Law, 42, 309 (2002)
Chounta A, Ann Intern Med, 143, 763 (2005)
Bibliographic reference
Cassiman, David ; Roelants, Mieke ; Vandenplas, Gerda ; Van der Merwe, Schalk W ; Mertens, Ann ; et. al. Orlistat treatment is safe in overweight and obese liver transplant recipients: a prospective, open label trial.. In: Transplant International, Vol. 19, no.12, p. 1000-1005 (2006)