Prospective Pilot Study for the Evaluation of Endoscopic Sleeve Gastroplasty With Endomina® for the Treatment of Obesity in Liver Transplant Candidates (ESGiTX)

Inclusion Criteria: Adult patients (i.e., age between 18 and 70 years). BMI ≥ 35 kg/m²; Subjects with an indication to liver transplantation that are not listed because of a high BMI according to the policy of the transplant Centre (cut-off 35 kg/m2); Signed informed consent. Exclusion Criteria: Clinically significant portal hypertension at upper endoscopy: F3 or F1/F2 with red signs oesophageal varices, gastric varices or severe hypertensive gastropathy; Upper gastro-intestinal bleeding (gastric or esophageal) in the previous six months; CHILD C class; Clinically or ultrasound-detected ascites in the 15 days before the procedure. Only mild ascitic effusion in the pelvis will be accepted; Spontaneous bacterial peritonitis in the previous 6 months; Hepatocellular carcinoma with extra hepatic spread; Previous stomach, oesophagus or duodenum surgery; Technical non-feasibility in the opinion of the endoscopist; Clinical signs of active infection; Unstable cardiac disease or chronic heart failure; Platelet count less than 70.000; Internationa Normalized Ratio ≥ 1,5; Concomitant unstoppable anticoagulant or anti platelet therapy, except for low dose aspirin (≤ 100 mg); Acute liver failure; Easy to bleed during diagnostic endoscopy; Active drugs or alcohol abuse; Pregnancy, lactation (desire to become pregnant during study duration); Enrolment in other clinical studies; Contraindication to general anaesthesia; Contraindication to endoscopic procedure; Other conditions to exclude the subject in investigators opinion; Refusal to sign informed consent.