Long-term Outcomes in Patients Undergoing Liver Transplantation for Nonalcoholic Steatohepatitis-Related Cirrhosis

Abstract

Recurrent NAFLD is common post-LT occurring in nearly 88% of all patients, whereas nearly a quarter of patients were noted to have advanced fibrosis.

Fatty allograft and cardiovascular outcomes after liver transplantation

“…Statin use has also been shown to be protective and is associated with better survival . However, it may be underused .…”

“…On the basis of current data, overall survival is similar in patients with and without recurrent NAFLD . Nor is there a difference in survival when patients with recurrent NAFLD are compared with patients with recurrent NASH . These data may be due to shorter length of follow‐up which fails to capture the progression of NASH to cirrhosis and graft loss, and thus may take up to a decade.…”

“…The recurrence rate of NAFLD in patients transplanted for NASH has been described as high as 90%‐100% . Up to one‐third of recipients with recurrent steatosis will develop NASH .…”

“…Up to one‐third of recipients with recurrent steatosis will develop NASH . The risk of developing advanced fibrosis or cirrhosis also increases with time, affecting approximately 25% of patients with allograft steatosis . Not surprisingly, the risk of advanced fibrosis is higher in patients who develop NASH (30% at 10 years) when compared with those who have simple steatosis …”

“…The most common cardiac complications that were seen included acute pulmonary edema, new‐onset atrial fibrillation, and sudden cardiac arrest, and these events tend to occur early after transplant and thus are unlikely to be related to recurrent NASH. Cardiovascular complications are the second most common cause of death following malignancy and infections in NASH patients and account for 22% of deaths in longterm follow‐up …”