Liver transplantation for nonalcoholic fatty liver disease: New challenges and new opportunities

Shaker, Mina; Tabbaa, Adam; Albeldawi, Mazen; Alkhouri, Naim

doi:10.3748/wjg.v20.i18.5320

Cited by 104 publications

(100 citation statements)

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“…177 It is expected that NAFLD may become the major reason for living-donor transplantation in the United States by 2030. 178 Although bariatric surgery is currently recognized as the standard treatment option for morbid obesity and its related comorbidities, the number of operations performed is far from sufficient to meet the need for intervention. In fact, less than 500,000 bariatric surgery procedures are performed worldwide every year today.…”

Section: 176mentioning

confidence: 99%

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

2017

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CONTEXT AND OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has been increasingly diagnosed worldwide and is now recognized as a source of public health concern. It comprises a wide spectrum of histological features that range from simple steatosis to severe forms of fibrosis, steatohepatitis and even cirrhosis. The impact of bariatric surgery on the course of NAFLD in individuals with obesity has been extensively studied. DESIGN AND SETTING: Narrative review; public university hospital. METHODS: A comprehensive review was conducted based on an online search on the electronic databases MEDLINE and LILACS using the MeSH terms "fatty liver" and "bariatric surgery". RESULTS:The exact mechanisms that lead to improvement in NAFLD following bariatric surgery are not completely understood. Since Roux-en-Y gastric bypass (RYGB) is the bariatric surgical procedure most performed worldwide, it is also the one from which the effects on NAFLD have been most studied, although there is also consistent evidence regarding the effects from gastric banding, sleeve gastrectomy and biliopancreatic diversions. CONCLUSION: According to the currently available evidence, bariatric surgery leads to significant improvement in NAFLD. Further research, especially by means of randomized controlled trials enrolling larger cohorts of individuals, is needed to determine the optimal procedure for this group of subjects. RESUMO CONTEXTO E OBJETIVO:A doença hepática gordurosa não alcoólica (DHGNA) tem sido diagnosticada com maior frequência em todo o mundo na atualidade, sendo agora reconhecida como motivo de preocupação em saúde pública. Abrange um amplo espectro de alterações histológicas que variam desde a simples esteatose até formas graves de fibrose, esteato-hepatite e até cirrose. O impacto da cirurgia bariátrica sobre o curso da DHGNA em indivíduos com obesidade tem sido profundamente estudado. TIPO DE ESTUDO E LOCAL: Revisão narrativa; hospital universitário público. MÉTODOS: Uma revisão abrangente da literatura foi conduzida baseada na pesquisa on-line nas bases de dados eletrônicas MEDLINE e LILACS por meio dos termos MeSH "fígado gorduroso" e "cirurgia bariátrica". RESULTADOS: Os mecanismos exatos que levam à melhora da DHGNA após a cirurgia bariátrica não são completamente conhecidos. Como o bypass gástrico em Y de Roux é a cirurgia bariátrica mais realizada em todo o mundo, é também o procedimento cujos efeitos sobre DHGNA foram mais estudados, embora haja também evidências consistentes sobre os efeitos de banda gástrica, gastrectomia vertical e derivações biliopancreáticas. CONCLUSÃO: De acordo com as evidências atualmente disponíveis, a cirurgia bariátrica leva à melhora significativa da DHGNA. Mais estudos, especialmente por meio de ensaios clínicos randomizados e controlados, recrutando coortes maiores de indivíduos, são necessários para determinar o melhor procedimento para esse grupo de pacientes.

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Section: 176mentioning

confidence: 99%

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

2017

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“…Metagenomics have also identified lung adapted strains of atypical bacteria suggesting novel pathogens (15). Metagenomics and metatranscriptomics have also identified novel metabolic functions in the CF airway that form a metabolic link between Streptococcus and both Pseudomonas and Rothia (25,26). The CF airway hosts a diverse microbial community that we are just beginning to elucidate.…”

Section: Results/conclusionmentioning

confidence: 99%

“…For example, intestinal translocation of specific microbiota in mice, and the detection of specific microbiota in people, are associated with the development of non-alcoholic fatty liver disease and steatohepatitis, common precursors to hepatic fibrosis (22)(23)(24), and common indications for liver transplant in adults (25). Studies in mice have also demonstrated that CFTR dysfunction can predispose to liver fibrosis (26).…”

Section: S51 Cf Liver Disease: Clinical Presentations and Definitionsmentioning

confidence: 99%

Symposium Session Summaries

2014

Pediatric Pulmonology

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“…The pathogenesis of NAFLD has not been fully understood, but it is observed that obesity, diabetes and hyperlipidemia are the major risk factors which are associated with development of non-alcoholic fatty liver disease [4,5,6]. NAFLD is most prevalent disease in developed [7] as well as in developing countries. In India the prevalence rate of NAFLD is 9-32% in among population [8].…”

Section: Introductionmentioning

confidence: 99%

Study of serum ferritin, serum uric acid and plasma malondialdehyde (MDA) levels in non-alcoholic fatty liver disease

Varma¹,

Makwane²,

Kare³

et al. 2016

Int J of Biomed & Adv Res

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Background: Non-alcoholic fatty liver disease (NAFLD) is one of most important cause of fatty liver that may lead to endstage liver disease. Various studies have reported that serum ferritin, serum uric acid and plasma malondialdehyde (MDA) levels are related to the development of NAFLD. Diabetes and obesity are the major risk factors which are associated with NAFLD. The aim of this study was estimation of serum ferritin, serum uric acid and plasma MDA levels in NAFLD patients with diabetes and with obesity. Materials and Methods:In the present study, total (n = 230) subjects were recruited for the study and divided in three groups. Group I; (n = 79) diagnosed cases of non-alcoholic fatty liver disease with diabetes, group II; (n = 71) diagnosed cases of nonalcoholic fatty liver disease with obesity patients and group III included (n = 80) healthy control subjects. Serum ferritin was measured by ELISA method. Estimation of serum uric acid was done by uricase peroxidase colorimetric method. Plasma MDA was estimated by spectrophotometric method. Results: The present study shown that serum ferritin, serum uric acid and plasma MDA levels were significantly increased (p<0.001) in NAFLD with diabetes mellitus patients (333.42±82.93, 14.29±1.87, 7.75±3.35, respectively) as compared with healthy controls (126.30±72.12, 5.19±1.72, 2.79±0.52, respectively), and also significantly increased (p < 0.001) in NAFLD with obesity patients (300.87±85.80, 12.08±2.81, 7.43±3.05, respectively) when they compared with healthy controls (126.30±72.12, 5.19±1.72, 2.79±0.52, respectively). Conclusion: Serum ferritin, serum uric acid and plasma MDA are associated with the increased risk for non-alcoholic fatty liver disease.

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Liver transplantation for nonalcoholic fatty liver disease: New challenges and new opportunities

Cited by 104 publications

References 0 publications

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Symposium Session Summaries

Study of serum ferritin, serum uric acid and plasma malondialdehyde (MDA) levels in non-alcoholic fatty liver disease

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