NASH: The Ethical Dilemma

Reference work entry
First Online:
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Nonalcoholic fatty liver disease, the hepatic manifestation of the metabolic syndrome, is a disease whereby increasing steatosis can potentially lead to steatohepatititis or nonalcoholic steatohepatitis. Continuing inflammation may lead to cirrhosis in as many as 25 % of patients. Nonalcoholic fatty liver disease is considered to be the most common form of chronic liver disease, and current population trends dictate that more patients will need liver transplants for this disease. While overall survival outcomes are equivalent to other forms of liver disease, this may at least partly be a result of current screening of patients which eliminates those patients who have the most risk factors for cardiovascular disease, the most common cause of poor outcomes following liver transplant in patients with nonalcoholic fatty liver disease. Immunosuppression may accelerate recurrence of the metabolic syndrome and nonalcoholic steatohepatitis post transplant.

Keywords

Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Cirrhosis Liver transplant Metabolic syndrome Insulin resistance Obesity 
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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Lankenau Medical CenterWynnewoodUSA
  2. 2.Sidney Kimmel Medical College at Thomas Jefferson UniversityLankenau Medical CenterWynnewoodUSA

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