Abstract
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) have emerged—along with the worldwide epidemic obesity—as the leading cause of chronic liver disease and cirrhosis or liver cancer secondary to fatty liver disease may become the most common indication for liver transplantation in the Western world in the near future. Recurrence of fatty liver disease following liver transplantation is not unusual—leading at least in a small number of patients to hepatic fibrosis and eventually liver cirrhosis which may require a second transplant. NASH patients frequently carry metabolic risk factors including obesity, diabetes, hypertension, and hyperlipidemia. These metabolic derangements persist following liver transplantation resulting in cardiovascular events—which is considered today the leading cause of death following liver transplantation in NASH recipients, surpassed only by sepsis. Patients with NASH cirrhosis should be carefully evaluated and selected for liver transplantation, and metabolic risk factors should be treated aggressively.
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References
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735–52.
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287(3):356–9.
Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346:1221–31.
Wong RJ, Aguilar M, Cheung R, et al. Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology. 2015;148(3):547–55.
Burke A, Lucey MR. Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis and orthotopic liver transplantation. Am J Transplant. 2004;4:686–93.
Caldwell SH, Oelsner DH, Iezzoni JC, et al. Cryptogenic cirrhosis: clinical characterization and risk factors for underlying disease. Hepatology. 1999;29:664–9.
Albeldawi M, Aggarwal A, Madhwal S, et al. Cumulative risk of cardiovascular events after orthotopic liver transplantation. Liver Transpl. 2012;18(3):370–5.
Charlton M, Kasparova P, Weston S, et al. Frequency of nonalcoholic steatohepatitis as a cause of advanced liver disease. Liver Transpl. 2001;7(7):608–14.
Hanouneh IA, Macaron C, Lopez R, et al. Recurrence of disease following liver transplantation: nonalcoholic steatohepatitis vs hepatitis C virus infection. Int J Organ Transplant Med. 2011;2(2):57–65.
Seo S, Maganti K, Khehra M, et al. De novo nonalcoholic fatty liver disease after liver transplantation. Liver Transpl. 2007;13(6):844–7.
Hanouneh IA, Feldstein AE, Lopez R, et al. Clinical significance of metabolic syndrome in the setting of chronic hepatitis C virus infection. Clin Gastroenterol Hepatol. 2008;6(5):584–9.
Shintani Y, Fujie H, Miyoshi H, et al. Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance. Gastroenterology. 2004;126(3):840–8.
Saab S, Shpaner A, Zhao Y, et al. Prevalence and risk factors for diabetes mellitus in moderate term survivors of liver transplantation. Am J Transplant. 2006;6(8):1890–5.
Hanouneh IA, Feldstein AE, McCullough AJ, et al. The significance of metabolic syndrome in the setting of recurrent hepatitis C after liver transplantation. Liver Transpl. 2008;14(9):1287–93.
Laryea M, Watt KD, Molinari M, et al. Metabolic syndrome in liver transplant recipients: prevalence and association with major vascular events. Liver Transpl. 2007;13:1109–14.
Bianchi G, Marchesini G, Marzocchi R, et al. Metabolic syndrome in liver transplantation: relation to etiology and immunosuppression. Liver Transpl. 2008;14:1648–54.
Ciccarelli O, Kaczmarek B, Roggen F, et al. Long-term medical complications and quality of life in adult recipients surviving 10 years or more after liver transplantation. Acta Gastroenterol Belg. 2005;68(3):323–30.
Neal DA, Tom BD, Luan J, et al. Is there disparity between risk and incidence of cardiovascular disease after liver transplant? Transplantation. 2004;77(1):93–9.
Sheiner PA, Magliocca JF, Bodian CA, et al. Long-term medical complications in patients surviving > or = 5 years after liver transplant. Transplantation. 2000;69(5):781–9.
Johnston SD, Morris JK, Cramb R, et al. Cardiovascular morbidity and mortality after orthotopic liver transplantation. Transplantation. 2002;73(6):901–6.
Wang X, Li J, Riaz DR, et al. Outcomes of liver transplantation for nonalcoholic steatohepatitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014;12:394–402.
Vanwagner LB, Bhave M, Te HS, et al. Patients transplanted for nonalcoholic steatohepatitis are at increased risk for postoperative cardiovascular events. Hepatology. 2012;56:1741–50.
Pawarode A, Fine DM, Thuluvath PJ. Independent risk factors and natural history of renal dysfunction in liver transplant recipients. Liver Transpl. 2003;9(7):741–7.
Modaresi Esfeh J, Hanouneh IA, Dalal D, et al. The incidence and risk factors of de novo skin cancer in the liver transplant recipients. Int J Organ Transplant Med. 2012;3(4):157–63.
Ascha MS, Hanouneh IA, Lopez R, et al. The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis. Hepatology. 2010;51(6):1972–8.
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Disclosures: Bijan Eghtesad: Nothing to disclose
Ibrahim Hanouneh: Nothing to disclose
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Hanouneh, I., Eghtesad, B. (2016). Nonalcoholic Fatty Liver Disease Post-Liver Transplantation. In: Thuluvath, P. (eds) Disease Recurrence After Liver Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2947-4_10
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DOI: https://doi.org/10.1007/978-1-4939-2947-4_10
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