Nonalcoholic Fatty Liver Disease Epidemic and Its Implications for Liver Transplantation

Kemmer, Nyingi; Neff, Guy; Franco, E; Osman-Mohammed, Hussein; Leone, John P.; Parkinson, Erin; Cece, Elizabeth; Alsina, Ángel

doi:10.1097/01.tp.0000436723.59879.01

Cited by 68 publications

(33 citation statements)

References 12 publications

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“…Using the united network for organ sharing database it was reported that approximately 7.7% of all adult liver recipients exhibited NASH-related cirrhosis during the period 2007–2010. 69 In US adults, NASH-associated cirrhosis is the second most common indication for liver transplantation. 70 …”

Section: Discussionmentioning

confidence: 99%

Comparison of the Phenotype and Approach to Pediatric vs Adult Patients With Nonalcoholic Fatty Liver Disease

et al. 2016

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Nonalcoholic fatty liver disease (NAFLD) is one of the main chronic non-communicable diseases in westernized societies; its worldwide prevalence has doubled during the last 20 years. NAFLD has serious health implications not only for adults, but also for children. However, pediatric NAFLD is not only an important global problem in itself, but it is likely to be associated with increases in comorbidities such as metabolic syndrome and cardiovascular diseases. There are several differences between NAFLD in children and adults and it is not clear whether the disease observed in children is the initial phase of a process that progresses with age. The increasing prevalence of pediatric NAFLD has serious implications for the future adult population requiring appropriate action. Studies of NAFLD progression, pathogenesis, and management should evaluate disease phenotypes in children and follow these over patient lifetimes. We review the similarities and differences of NAFLD between children and adults.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Phenotype and Approach to Pediatric vs Adult Patients With Nonalcoholic Fatty Liver Disease

et al. 2016

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“…; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, J. as hepatic steatosis or hepatic fibrosis, were the main reasons for exclusion from donation in potential adult living liver transplantation donors (7)(8)(9). Recently, nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH), has increasingly been recognized as the most common chronic liver disease worldwide, with reports of an increasing prevalence of NASH in the United States (10). This increasing prevalence of NAFLD in the general population poses a risk for organ donation, since allograft steatosis has been reported to be associated with nonfunctioning grafts (11,12), and the first case of living liver transplantation donor death was reported in Japan in a donor with NASH (5).…”

Section: Author Contributionsmentioning

confidence: 99%

Combined Use of MR Fat Quantification and MR Elastography in Living Liver Donors: Can It Reduce the Need for Preoperative Liver Biopsy?

Yoon¹,

Lee²,

Suh³

et al. 2015

Radiology

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Purpose:To evaluate the diagnostic performance of magnetic resonance (MR) fat quantification and MR elastography for the assessment of hepatic steatosis and fibrosis in living liver donor candidates. Materials and Methods:This retrospective study was approved by the institutional review board, and the requirement of informed consent was waived. Donors who underwent MR fat quantification and MR elastography at 1.5 T, followed by liver biopsy, were chronologically grouped into test and validation groups. In the test group (n = 362), MR fat fraction and liver stiffness were compared among donors with normal parenchyma (n = 244), simple steatosis (n = 71), steatosis with inflammatory activity (n = 21), nonalcoholic steatohepatitis (n = 17), and fibrosis (n = 9). Diagnostic performance of the two techniques was assessed by using receiver operating characteristic curve analysis for the detection of substantial steatosis (macrovesicular fat  10%) or fibrosis (F1) and was tested in a validation group (n = 34). Results:In the test group, donors with steatosis showed significantly higher fat fraction than donors without steatosis (P , .0001), and donors with fibrosis and nonalcoholic steatohepatitis showed significantly higher liver stiffness values than donors without fibrosis (P , .0001). Areas under the curve were 0.93 (cutoff value . 5.8%) for MR fat quantification and 0.85 (cutoff value . 1.94 kPa) for MR elastography. By using those values, the combination of the two techniques could be used to detect substantial steatosis or fibrosis with 100% sensitivity (12 of 12 patients, 95% confidence interval: 73.4%, 100%) and 100% negative predictive value (15 of 15 patients, 95% confidence interval: 78.0%, 100%) in the validation group. Conclusion:A combination of MR fat quantification and MR elastography can provide sufficient sensitivity to detect substantial steatosis or fibrosis (F1) in liver donor candidates.q RSNA, 2015

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“…Because in it was first established as a distinct category for liver transplant in 2000, the number of liver transplants for patients with NASH has increased, accounting for approximately 8% to 10% of all liver transplants in 2009, 2,3 especially among recipients > 65 years old and with more performed in Southeastern and Midwestern regions of the United States. 4 Patients with metabolic syndrome because of concomitant comorbidities such as diabetes, hypertension, obesity, and dyslipidemia are more likely to present with atherosclerosis and its complications and have an increased risk for cardiovascular and all-cause mortality. 5,6 In addition, the use of potent immunosuppressive agents among liver transplant recipients increases the risk of developing the metabolic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Piazza

Singal²

2016

Exp Clin Transplant

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Objectives: Frequency of liver transplants because of nonalcoholic steatohepatitis is increasing. Data are conflicting on nonalcoholic steatohepatitis as a risk factor for cardiovascular events after transplant. Materials and Methods:We reviewed medical records of liver transplant recipients (between years 2005 and 2010) for alcoholic cirrhosis or nonalcoholic steatohepatitis for cardiovascular events (arrhythmia, congestive heart failure, coronary disease, pulmonary hypertension, or stroke) and patient survival within 3 years. Results: Compared with the 65 transplant recipients for alcoholic cirrhosis, the 78 transplant recipients for nonalcoholic steatohepatitis were significantly (P < .0001 for all) more likely to be female (46% vs 8%), have a larger mean body mass index (34 ± 7 vs 29 ± 5), more likely to have diabetes (58% vs 26%), less likely to be hepatitis C virus-positive (3% vs 29%), and less likely to smoke (29% vs 69%). Eleven patients with nonalcoholic steatohepatitis and 9 patients with nonalcoholic steatohepatitis had cardiovascular events; however, these groups were not significantly different 1 year (7.7% vs 6.1%; P = .45) or 3 years (14.1% vs 13.8%; P = .9) after liver transplant. The odds of having a cardiovascular event were about 9-fold greater for patients with concomitant hepatitis C virus and 3-fold greater for men. Eighteen patients died, with patients with cardiovascular events having greater than 4-fold increased mortality (mean 4.1-fold; range, 1.2-fold to 13.9-fold). Conclusions: Cardiovascular events occurred with similar frequency in transplant recipients for nonalcoholic steatohepatitis or alcoholic cirrhosis. Patient survival was affected in both groups, but male patients with concomitant hepatitis C virus infection remained at higher risk for a cardiovascular event after liver transplant. Development of a cardiac evaluation protocol for liver transplant recipients could help monitor these patients.

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Nonalcoholic Fatty Liver Disease Epidemic and Its Implications for Liver Transplantation

Cited by 68 publications

References 12 publications

Comparison of the Phenotype and Approach to Pediatric vs Adult Patients With Nonalcoholic Fatty Liver Disease

Comparison of the Phenotype and Approach to Pediatric vs Adult Patients With Nonalcoholic Fatty Liver Disease

Combined Use of MR Fat Quantification and MR Elastography in Living Liver Donors: Can It Reduce the Need for Preoperative Liver Biopsy?

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