Recurrent disease following liver transplantation for nonalcoholic steatohepatitis cirrhosis
Open Access
- 24 November 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Liver Transplantation
- Vol. 15 (12), 1843-1851
- https://doi.org/10.1002/lt.21943
Abstract
Recurrence of the original disease following liver transplantation is not uncommon and can lead to graft failure. There are limited data on recurrent fatty liver disease following liver transplantation. The aim of this study was to determine the incidence of recurrent fatty liver disease in patients with biopsy-proven nonalcoholic steatohepatitis, its effect on survival, and whether there are any predictive factors for recurrence. We analyzed patients undergoing liver transplantation for nonalcoholic steatohepatitis cirrhosis from 1997 to 2008 at a single center. Patients undergoing transplantation for cholestatic disease, alcohol, hepatitis C, or cryptogenic cirrhosis were controls. Ninety-eight patients underwent transplantation for nonalcoholic steatohepatitis cirrhosis. Recurrent fatty liver disease was seen in 70%, 25% had recurrent nonalcoholic steatohepatitis, and 18% had stage II/IV or greater fibrosis at a mean of 18 months. No patients with recurrent nonalcoholic steatohepatitis developed graft failure or required retransplantation at a follow-up of 3 years. No recipient or donor factors were associated with disease recurrence, although patients with recurrent nonalcoholic steatohepatitis had a higher incidence of diabetes, weight gain, and dyslipidemia at the time of diagnosis of recurrence. One-third of patients with recurrent nonalcoholic steatohepatitis had normal liver enzymes at the time of diagnosis post-transplantation. In conclusion, recurrent fatty liver disease is common following liver transplantation for nonalcoholic steatohepatitis cirrhosis but does not lead to early allograft failure. Recurrent nonalcoholic steatohepatitis can occur despite normal liver enzymes, and features of metabolic syndrome are associated with disease recurrence. Liver Transpl 15:1843–1851, 2009. © 2009 AASLD.Keywords
This publication has 41 references indexed in Scilit:
- Outcome After Liver Transplantation for NASH CirrhosisAmerican Journal of Transplantation, 2009
- Randomized, Placebo-Controlled Trial of Pioglitazone in Nondiabetic Subjects With Nonalcoholic SteatohepatitisGastroenterology, 2008
- Identifying risk for recurrent hepatocellular carcinoma after liver transplantation: Implications for surveillance studies and new adjuvant therapiesLiver Transplantation, 2008
- Risk factors for recurrence of primary sclerosing cholangitis after liver transplantationLiver Transplantation, 2008
- Long‐term follow‐up after recurrence of primary biliary cirrhosis after liver transplantation in 100 patientsClinical Transplantation, 2006
- Cryptogenic cirrhosis: Clinical characterization and risk factors for underlying diseaseJournal of Hepatology, 1999
- What is the significance of acute liver allograft rejection?Journal of Hepatology, 1998
- The prediction of risk of recurrence and time to recurrence of hepatocellular carcinoma after orthotopic liver transplantation: A pilot studyJournal of Hepatology, 1997
- Recurrence of nonalcoholic steatohepatitis in a liver transplant recipientLiver Transplantation and Surgery, 1997
- LIVER TRANSPLANTATION FOR CIRRHOSIS FOLLOWING JEJUNO-ILEAL BYPASS—REGIONAL CYTOKINE DIFFERENCES ASSOCIATED WITH PATHOLOGICAL CHANGES IN THE TRANSPLANT LIVERTransplantation, 1992