Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 06 / 27 / 2019

Articles

Nonalcoholic Fatty Liver Disease: Epidemiology, Liver Transplantation Trends and Outcomes, and Risk of Recurrent Disease in the Graft

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Nonalcoholic Fatty Liver Disease: Epidemiology, Liver Transplantation Trends and Outcomes, and Risk of Recurrent Disease in the Graft

Andy Liu*,1, Artin Galoosian1, Dharmesh Kaswala2, Andrew A. Li3, Chiranjeevi Gadiparthi4, George Cholankeril3, Donghee Kim3 and Aijaz Ahmed3

1California Pacific Medical Center, Department of Medicine, San Francisco, CA, USA
2California Pacific Medical Center, Division of Gastroenterology and Hepatology, San Francisco, CA, USA
3Stanford University School of Medicine, Division of Gastroenterology and Hepatology, Stanford, CA, USA
4University of Tennessee Health Science Center, Division of Gastroenterology and Hepatology, Memphis, TN, USA

*Correspondence to: Andy Liu, Department of Medicine, California Pacific Medical Center 2351 Clay Street, Suite 380, San Francisco, CA 94110, USA. Tel: +1-415-600-3954, Fax: +1-415-775-7437, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(4):420-424 DOI: 10.14218/JCTH.2018.00010
Received: February 15, 2018 Accepted: May 31, 2018 Published online: July 28, 2018

Abstract

In parallel with the rising prevalence of metabolic syndrome globally, nonalcoholic fatty liver (NAFL) disease is the most common chronic liver disease in Western countries and nonalcoholic steatohepatitis (NASH) has become increasingly associated with hepatocellular carcinoma. Recent studies have identified NASH as the most rapidly growing indication for liver transplantation (LT). As a hepatic manifestation of the metabolic syndrome, NAFL disease can be histologically divided into NAFL and NASH. NAFL is considered a benign condition, with histological changes of hepatocyte steatosis but without evidence of hepatocellular injury or fibrosis. This is distinct from NASH, which is characterized by hepatocyte ballooning and inflammation, and which can progress to fibrosis and cirrhosis, hepatocellular carcinoma, and liver failure. As for any other end-stage liver disease, LT is a curative option for NASH after the onset of decompensated cirrhosis or hepatocellular carcinoma. Although some studies have suggested increased rates of sepsis and cardiovascular complications in the immediate postoperative period, the long-term posttransplant survival of NASH cases is similar to other indications for LT. Recurrence of NAFL following LT is common and can be challenging, although recurrence rates of NASH are lower. The persistence or progression of metabolic syndrome components after LT are likely responsible for NASH recurrence in transplanted liver. Therefore, while maintaining access to LT is important, concerted effort to address the modifiable risk factors and develop effective screening strategies to identify early stages of disease are paramount to effectively tackle this growing epidemic.

Keywords

Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis, Liver transplantation, Epidemiology, Trends

 

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 420-424  [ Html ] [ PDF Full-text ]

 

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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