Nonalcoholic fatty liver disease and liver transplantation - Where do we stand?

Apr 18, 2018World journal of gastroenterology

Current Status of Nonalcoholic Fatty Liver Disease and Liver Transplantation

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Abstract

Nonalcoholic fatty liver disease may soon be a leading cause for liver transplantation due to rising rates of metabolic syndrome.

NAFLD/NASH significantly impacts liver transplantation outcomes and candidate selection.
The increasing prevalence of metabolic syndrome is linked to a rise in NASH cirrhosis and hepatocellular carcinoma.
More steatotic donor livers are expected, reducing the availability of high-quality organs for transplantation.
Patients with NASH who are considered for liver transplantation often present with multiple comorbidities.
Recurrence of NASH and new onset of NASH after transplantation is a concern that warrants further investigation.

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Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a challenging and multisystem disease that has a high socioeconomic impact. NAFLD/NASH is a main cause of macrovesicular steatosis and has multiple impacts on liver transplantation (LT), on patients on the waiting list for transplant, on post-transplant setting as well as on organ donors. Current data indicate new trends in the area of chronic liver disease. Due to the increased incidence of metabolic syndrome (MetS) and its components, NASH cirrhosis and hepatocellular carcinoma caused by NASH will soon become a major indication for LT. Furthermore, due to an increasing incidence of MetS and, consequently, NAFLD, there will be more steatotic donor livers and less high quality organs available for LT, in addition to a lack of available liver allografts. Patients who have NASH and are candidates for LT have multiple comorbidities and are unique LT candidates. Finally, we discuss long-term grafts and patient survival after LT, the recurrence of NASH and NASH appearingafter transplantation. In addition, we suggest topics and areas that require more research for improving the health care of this increasing patient population. de novo

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Nonalcoholic fatty liver disease and liver transplantation - Where do we stand?

Abstract

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