Nonalcoholic steatohepatitis before and after liver transplant: keeping up with the times

Expert Review of Gastroenterology & Hepatology
Stefano GittoPatrizia Burra

Abstract

In the last years, nonalcoholic steatohepatitis (NASH) has become a leading indication for liver transplant (LT). After transplant, both recurrent and de novo nonalcoholic fatty liver disease (NAFLD) can be commonly diagnosed. However, dedicated surveillance programs for patients with pre- or post-transplant NAFLD are not available. Areas covered: Patients waiting for LT for NASH show specific peculiarities and would deserve targeted stratification of mortality risk. Obesity, hyperlipidemia, and diabetes mellitus can be often found after transplant. These conditions, together with immunosuppressive regimen, make LT recipients a high-risk population for both recurrent and de novo NAFLD. Development of fatty liver disease after LT has a relevant impact on both morbidity and mortality. Expert commentary: A targeted stratification of neoplastic and cardiovascular risk for patients with NASH waiting for LT would be mandatory. In both pre- and post-transplant period, NAFLD should be considered not only a liver disease but also a cardiovascular risk factor. Patients within Transplant Program, especially those with known metabolic risk factors, should be followed with personalized diagnostic and life-style interventions before and afte...Continue Reading

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Citations

Oct 15, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Thomas G Cotter, Michael Charlton
Jun 13, 2021·Updates in Surgery·Fernando de Barros, Pedro Henrique Cardoso Faleiro Uba
Feb 2, 2022·Updates in Surgery·Eduardo de Souza M FernandesOrlando Jorge M Torres

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