Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges

Samji, Naga Swetha; Verma, Rajanshu; Keri, Krishna; Singal, Ashwani K.; Ahmed, Aijaz; Rinella, Mary E.; Bernstein, David; Abdelmalek, Manal F.

doi:10.1007/s10620-019-05716-1

Cited by 11 publications

(10 citation statements)

References 177 publications

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“…Physicians tend to focus on treating renal dysfunction and liver-related morbidities and mortalities in liver fibrosis patients. Recent reports have drawn attention to the cardiovascular aspects of fatty liver disease, which are becoming the major cause of liver transplantation in westernized societies 43,44 .…”

Section: Discussionmentioning

confidence: 99%

The risk of atrial fibrillation in patients with non-alcoholic fatty liver disease and a high hepatic fibrosis index

Park

Lee

Choi

et al. 2020

Sci Rep

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Previous epidemiological studies focusing on the association between liver disease and atrial fibrillation (AF) show interesting but inconsistent findings. Patients with liver disease have a higher AF risk; however, it is unknown whether the liver fibrosis index can predict AF risk. The medical records of a healthy population undergoing routine health examinations at Healthcare System Gangnam Center, Seoul National University Hospital, were reviewed retrospectively. After excluding subjects with a history of liver disease and known cardiovascular disease, 74,946 subjects with nonalcoholic fatty liver disease (NAFLD) were evaluated. The mean age was 51 ± 11 years, and 71.9% were male. AF was found in 380 (0.5%) subjects. Using univariate analyses, age, male sex, body mass index, hypertension, and diabetes were significantly associated with AF. The fibrosis 4 index (FIB 4) showed significant correlations with AF [unadjusted odds ratio (OR) 3.062 and 95% confidence interval (CI) 2.605-3.600, p = 0.000; adjusted OR 2.255 and 95% CI 1.744-2.915, p = 0.000, with cardiometabolic risk factors adjusted]. In conclusion, NAFLD subjects with higher FIB 4 were associated with increased AF risk. The noninvasive determination of liver fibrosis indices can have clinical implications on the early identification of NAFLD in patients at risk for AF.Atrial fibrillation (AF) is gradually increasing in incidence and prevalence in Korea 1 . AF incidence increased more than 1.12-fold from 2008 to 2015, and the AF prevalence increased by 1.68-fold during the same period. An aging population and increasing comorbidities associated with the aging process have been suggested as explanations for these increases. A substantial increase in mortality and morbidity, reducing the quality of life in AF patients, is becoming a serious medical problem in Korea 1,2 . In addition to abnormal substrate and triggering ectopic foci in the heart, various inflammatory markers have been studied to identify a link between AF and systemic inflammation, but results are inconsistent 3 .The association of AF and liver disease, with increasing prevalence of non-alcoholic fatty liver disease (NAFLD) and subsequent cirrhosis world-wide, have shown interesting results. From various previous studies regarding relation between liver diseases and AF, results have been somewhat inconsistent. A recent meta-analysis reported an approximately two-fold increased risk of AF among NAFLD patients compared with subjects without NAFLD 4 . Patients with liver cirrhosis have a 46% increased AF risk compared to controls, after covariates were adjusted 5 . In that study, the AF risk was higher in a population younger than 65 years of age, without known cardiovascular comorbidities. Another study using the fatty liver index showed an increased risk for new-onset AF in subjects with NAFLD without significant coronary disease. NAFLD predisposes individuals to AF, independent of known risk factors for atherosclerosis 6 . Shared risk factors, epicardial fat and related hormonal and cytok...

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Section: Discussionmentioning

confidence: 99%

The risk of atrial fibrillation in patients with non-alcoholic fatty liver disease and a high hepatic fibrosis index

Park

Lee

Choi

et al. 2020

Sci Rep

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“…Numerous studies have characterized risk factors and prevalence of posttransplant NAFLD and NASH recurrence ( 26 ). A recent study showed that recurrent NAFLD post-LT occurred in 88% of patients, with nearly one-fourth patients having advanced fibrosis ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Genetic Risk Factors of Recurrent Nonalcoholic Fatty Liver Disease After Liver Transplantation

Tran

Kovalic

Bontha

et al. 2021

Clinical and Translational Gastroenterology

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INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) has been increasingly reported among recipients of liver transplantation (LT). We aimed to identify clinical and genetic risk factors responsible for the development of early recurrent NAFLD in nonalcoholic steatohepatitis transplant recipients. METHODS: Forty-six total single nucleotide polymorphisms with known association with NAFLD were tested among both recipient and donor liver samples in 66 LT recipients with nonalcoholic steatohepatitis to characterize influences on NAFLD recurrence at ∼1 year post-LT (median interval from LT to biopsy: 377 days). RESULTS: Recurrent NAFLD was identified in 43 (65.2%) patients, 20 (30.3%) with mild recurrence, and 23 (34.8%) with moderate to severe NAFLD. On adjusted analysis, change in the body mass index (BMI) (ΔBMI) was significantly associated with NAFLD recurrence, whereas post-LT diabetes mellitus was associated with increased severity of NAFLD recurrence. ADIPOR1 rs10920533 in the recipient was associated with increased risk of moderate to severe NAFLD recurrence, whereas the minor allele of SOD2 rs4880 in the recipient was associated with reduced risk. Similar reduced risk was noted in the presence of donor SOD2 rs4880 and HSD17B13 rs6834314 polymorphism. DISCUSSION: Increased BMI post-LT is strongly associated with NAFLD recurrence, whereas post-LT diabetes mellitus was associated with increased severity of NAFLD recurrence. Both donor and recipient SOD2 rs4880 and donor HSD17B13 rs6834314 single nucleotide polymorphisms may be associated with reduced risk of early NAFLD recurrence, whereas presence of the minor allele form of ADIPOR1 rs10920533 in the recipient is associated with increased severity NAFLD recurrence.

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“…A doença hepática gordurosa não alcoólica (DHGNA) foi descrita pela primeira vez em 1980, por Ludwing, et al, e desde então vem sendo estudada. Essa doença corresponde ao excesso de gordura acumulada em, no mínimo, 5% dos hepatócitos e possui uma fisiopatologia complexa, relacionada a comorbidades metabólicas, incluindo diabetes mellitus, dislipidemia, obesidade, síndrome metabólica (SM) e a adiposidade visceral, além de outros fatores de risco, como por exemplo, idade, obesidade, sexo masculino, resistência à insulina e fatores genéticos (ANTONUCCI et al, 2017;BELLENTANI et al, 2010;DIEHL;DAY, 2017;FESTI et al, 2004;MARCHESINI;RODEN;VETTOR, 2016;SAMJI et al, 2019;TORRES;HARRISON, 2012;YOUNOSSI et al, 2016). Trata-se de uma doença tipicamente associada à disfunção metabólica, não sendo então uma doença apenas de obesos (YOUNOSSI et al, 2016).…”

Section: Introductionunclassified

“…A DHGNA é a doença hepática mais comum no mundo, com prevalência crescente (SAMJI et al, 2019). A prevalência mundial varia entre 8% e 45% da população (FAZEL et al, 2016), nos quais 20% a 25% dos adultos apresentam DHGNA (YOUNOSSI et al, 2016).…”

Section: Introductionunclassified

“…Apesar de a DHGNA afetar grande parte da população, a doença apresenta um bom prognóstico; porém, em uma pequena parcela dos pacientes, principalmente obesos e diabéticos, a esteatose hepática é a principal causa para progressão da DHGNA, podendo evoluir até se tornar cirrose e possível hepatocarcinoma e, dessa forma, a DHGNA é a principal causa de doença hepática crônica, sendo, assim, um problema de saúde pública (ABENAVOLI et al, 2014;ADAMS;ANGULO, 2005;BELLENTANI et al, 2010;DIEHL;DAY, 2017). O potencial para se tornar uma doença mais grave pode acabar levando a uma condição onde apenas o transplante de fígado seja a opção de tratamento possível (SAMJI et al, 2019).…”

Section: Introductionunclassified

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Efeito do óleo de milho no metabolismo lipídico e estresse oxidativo em camundongos alimentados com dieta hiperlipídica e rica em frutose

Silva¹

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Dedico esse trabalho a Deus, que é meu guia, e ao meu pai Joaquim e a minha mãe Jeuvânia, que são meu porto seguro. AGRADECIMENTOSAgradeço primeiramente a Deus, por me dar forças durante essa trajetória, e me fazer entender cada ensinamento dessa caminhada chamada vida. Agradeço também aos meus pais, que nunca mediram esforços e estiverem sempre me apoiando em cada decisão, e a minha irmã, por dividir essa vida comigo. Agradeço ao meu namorado, por toda paciência e companheirismo durante essa trajetória.Agradeço também ao meu orientador, pela oportunidade, por me ajudar nos momentos que precisei e por todo ensinamento compartilhado. Aos colegas de laboratório que me ajudaram durante todo o do experimento.Agradeço em especial a minha amiga Isabella, minha companheira de mestrado, que esteve ao meu lado durante esses anos, dividindo todos os momentos bons e os ruins, sendo amiga presente, mesmo quando longe. Agradeço também de coração a Paula e ao Héric, um casal maravilhoso, no qual pude aprender e conviver, que sempre me ajudaram e ensinaram, uma troca maravilhosa, são pessoas que levarei para vida.Agradeço aos meus amigos de longa data, que me ajudaram, incentivaram e torceram pela minha conquista, levo cada um no meu coração. Agradeço também aos meus familiares mais próximos, que estiveram por perto vibrando cada conquista. Agradeço a cada um que passou por mim durante todo esse tempo e de alguma forma, boa ou ruim, me ajudou a evoluir! Agradeço à Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), pela bolsa concedida a pesquisa. O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brasil (CAPES) -Código de Financiamento 001. RESUMO SILVA, Raissa Yolanda de Oliveira. Efeito do óleo de milho no metabolismo lipídico e estresse oxidativo em camundongos alimentados com dieta hiperlipídica e rica em frutose. 2021. Dissertação (Mestrado

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Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges

Cited by 11 publications

References 177 publications

The risk of atrial fibrillation in patients with non-alcoholic fatty liver disease and a high hepatic fibrosis index

The risk of atrial fibrillation in patients with non-alcoholic fatty liver disease and a high hepatic fibrosis index

Clinical and Genetic Risk Factors of Recurrent Nonalcoholic Fatty Liver Disease After Liver Transplantation

Efeito do óleo de milho no metabolismo lipídico e estresse oxidativo em camundongos alimentados com dieta hiperlipídica e rica em frutose

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