A Single-Center Study of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Recurrence in Recipients of Liver Transplant for Treatment of Nonalcoholic Steatohepatitis Cirrhosis

Matsuoka, Lea; Chotai, Pranit N.; Slaughter, James C.; Campbell, Kathryn; Kerr, Ashlie; Hamel, Stephanie A.; Garza, Carissa; Alexopoulos, Sophoclis P.; Scanga, Andrew

doi:10.6002/ect.2021.0343

Cited by 3 publications

(1 citation statement)

References 41 publications

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“…Post-LT steatosis was reported in 31% of patients; however, bridging fibrosis or cirrhosis was only found in 5% and 10% of recipients after 5 years and 10 years, respectively[ 11 ]. In a recent retrospective study of 275 NASH recipients, the prevalence of NAFLD and NASH recurrence was 22% and 11%, respectively[ 12 ]. However, it should be underlined that most studies have important heterogeneity regarding NAFLD diagnosis and patient selection.…”

Section: Epidemiologymentioning

confidence: 99%

Growing challenge of post-liver transplantation non-alcoholic fatty liver disease

Kalogirou¹,

Γιουλεμέ²

2022

WJT

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Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma worldwide, with an estimated prevalence of 25%. Post-liver transplantation (LT) recurrent or de novo hepatic steatosis is a common complication in recipients, irrespective of transplantation indication. Risk factors for graft steatosis mainly include obesity, immunosuppression, donor steatosis, and genetic factors. Liver transplant recipients are at high risk of developing insulin resistance, new-onset diabetes, and post-transplantation metabolic syndrome that is highly associated with immunosuppressive treatment. Post-LT NAFLD is often underdiagnosed due to the poor sensitivity of most routine imaging methods. The gold standard for the diagnosis of hepatic steatosis is liver biopsy, which is, however, limited to more complex cases due to its invasive nature. There is no approved pharmacotherapy in NAFLD. Lifestyle modification remains the cornerstone in NAFLD treatment. Other treatment strategies in post-LT NAFLD include lifestyle modifications, pharmacotherapy, bariatric surgery, and tailored immunosuppression. However, these approaches originate from recommendations in the general population, as there is scarce data regarding the safety and efficacy of current management strategies for NAFLD in liver transplant patients. Future prospective studies are required to achieve tailored treatment for these patients.

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Section: Epidemiologymentioning

confidence: 99%

Growing challenge of post-liver transplantation non-alcoholic fatty liver disease

Kalogirou¹,

Γιουλεμέ²

2022

WJT

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NASH After Liver Transplantation: Impact of Immunosuppression

Taneja¹,

Roy²,

Duseja³

2023

Journal of Clinical and Experimental Hepatology

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Liver Allograft Cirrhosis, Retransplant, and Mortality Secondary to Recurrent Disease After Transplant for MASH: A Systematic Review and Meta-analysis

Jatana,

Krys,

Verhoeff

et al. 2024

Transplantation

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Background. Recurrent disease after liver transplant is well recognized for many diseases. Metabolic dysfunction–associated steatotic liver disease (MASLD) and steatohepatitis (MASH) are leading indications for liver transplant, and there is scarce knowledge about recurrence-related end outcomes such as retransplant and mortality. This project aims to assess the proportion of patients transplanted for MASH who develop recurrent disease and adverse clinical outcomes. Methods. A systematic review and pooled proportions meta-analysis was performed by searching the following databases: MEDLINE, Embase, Scopus, Web of Science Core Collection, and Cochrane Library. Inclusion criteria were studies discussing adult patients with liver transplants secondary to MASH or presumed MASH with recurrent disease-related outcomes. Outcomes were assessed in time frames from <6 mo to ≥5 y. Results. Of 5859 records, 40 were included (16 157 patients). Recurrent MASLD and MASH (28 studies each) occurred in frequencies of 35%–49% and 11%–24%, respectively. Fibrosis occurred in 4%–25% (13 studies). Recurrent disease-related cirrhosis (13 studies), graft failure (8 studies), and retransplant (9 studies) occurred in 0%–2%, 3%–9%, and 0%–1%, respectively. Recurrent disease-related hepatocellular carcinoma (1 study) and mortality (17 studies) both had a prevalence of 0%. Studies were of moderate or high quality using the Methodological Index for Non-Randomized Studies tool. Conclusions. Recurrent MASLD and MASH after liver transplant occur frequently, but adverse clinical outcomes due to disease recurrence are infrequent, maybe due to insufficient data on long-term follow-up. Long-term outcomes after transplantation for MASLD appear favorable; however, identifying those more likely to have progressive recurrent disease leading to adverse clinical outcomes may allow for pre- and posttransplant interventions to improve outcomes further.

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A Single-Center Study of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Recurrence in Recipients of Liver Transplant for Treatment of Nonalcoholic Steatohepatitis Cirrhosis

Cited by 3 publications

References 41 publications

Growing challenge of post-liver transplantation non-alcoholic fatty liver disease

Growing challenge of post-liver transplantation non-alcoholic fatty liver disease

NASH After Liver Transplantation: Impact of Immunosuppression

Liver Allograft Cirrhosis, Retransplant, and Mortality Secondary to Recurrent Disease After Transplant for MASH: A Systematic Review and Meta-analysis

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