Nonalcoholic fatty liver disease and liver transplantation

Angulo, Paul

doi:10.1002/lt.20738

Cited by 131 publications

(108 citation statements)

References 98 publications

(177 reference statements)

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“…The association of hepatic steatosis with inflammatory changes and fibrosis in obese patients was first described over 50 years ago (1) and can lead to liver failure in patients undergoing surgical jejunoileal bypass for morbid obesity (2) (4) and is considered the 'progressive' form of NAFLD (5).…”

Section: Introductionmentioning

confidence: 99%

Outcome After Liver Transplantation for NASH Cirrhosis

Malik¹,

DeVera

Fontes

et al. 2009

American Journal of Transplantation

193

164

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Nonalcoholic steatohepatitis (NASH) associated cirrhosis is an increasing indication for liver transplant (LT). The aim of this study was to determine outcome and poor predictive factors after LT for NASH cirrhosis. We analyzed patients undergoing LT from 1997 to 2008 at a single center. NASH was diagnosed on histopathology. LT recipients with hepatitis C, alcoholic or cholestatic liver disease and cryptogenic cirrhosis acted as matched controls.Ninety-eight LT recipients were identified with NASH cirrhosis. Compared to controls, NASH patients had a higher BMI (mean 32.3 kg/m 2 ), and were more likely to be diabetic and hypertensive. Mortality after transplant was similar between NASH patients and controls but there was a tendency for higher earlier mortality in NASH patients (30-day mortality 6.1%, 1-year mortality 21.4%). Sepsis accounted for half of all deaths in NASH patients, significantly higher than controls. NASH patients ≥60 years, BMI ≥30 kg/m 2 with diabetes and hypertension (HTN) had a 50% 1-year mortality.In conclusion, patients undergoing LT for NASH cirrhosis have a similar outcome to patients undergoing LT for other indications. The combination of older age, higher BMI, diabetes and HTN are associated with poor outcome after LT. Careful consideration is warranted before offering LT to these high-risk patients.

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Section: Introductionmentioning

confidence: 99%

Outcome After Liver Transplantation for NASH Cirrhosis

Malik¹,

DeVera

Fontes

et al. 2009

American Journal of Transplantation

193

164

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“…It is estimated that 3% of patients with NAFLD will develop liver-related complications (e.g., hepatocellular carcinoma) within 10 yr (2). Liver disease secondary to nonalcoholic steatohepatitis (NASH) is already a common indication for liver transplantation (3). The scale of the public health burden of NAFLD is likely to increase in parallel with increases in the prevalence and severity of obesity in the United States and globally.…”

mentioning

confidence: 99%

Fast food diet mouse: novel small animal model of NASH with ballooning, progressive fibrosis, and high physiological fidelity to the human condition

Charlton

Krishnan

Viker

et al. 2011

American Journal of Physiology-Gastrointestinal and Liver Physi

376

354

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Although there are small animal platforms that recapitulate some of the histological features of nonalcoholic fatty liver disease, there are no small animal models of nonalcoholic steatohepatitis (NASH) with consistent hepatocellular ballooning and progressive fibrosis that also exhibit fidelity to the human condition physiologically. We examined the metabolic and histological effects of a diet on the basis of the composition of “fast food” (high saturated fats, cholesterol, and fructose). Mice ( n = 8 in each group) were assigned to diets as follows: 1) standard chow (SC), i.e., 13% energy as fat [1% saturated fatty acids (SFA)], 2) high fat (HF), i.e., 60% energy as fat (1% SFA), and 3) fast food (FF), i.e., 40% energy as fat (12% SFA, 2% cholesterol). All three diets were supplemented with high fructose. All diets produced obesity. The HF and FF diets produced insulin resistance. Liver histology was normal in animals fed the SC diet. Steatohepatitis with pronounced ballooning and progressive fibrosis (stage 2) was observed in mice fed the FF diet. Although the HF diet produced obesity, insulin resistance, and some steatosis; inflammation was minimal, and there was no increase in fibrosis. The FF diet produced a gene expression signature of increased fibrosis, inflammation, and endoplasmic reticulum stress and lipoapoptosis. A diet based on high cholesterol, high saturated fat, and high fructose recapitulates features of the metabolic syndrome and NASH with progressive fibrosis. This represents a novel small animal model of fibrosing NASH with high fidelity to the human condition. These results highlight the contribution of dietary composition to the development of nonalcoholic fatty liver disease and NASH.

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“…Macrosteatosis of liver grafts increases the susceptibility to ischemia-reperfusion injury and is, therefore, closely related to the functional recovery of the graft after transplantation [24]. The cut-off value for macrosteatosis of 30% is accepted by most transplantation centers for graft acceptance [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

A Simple Model to Predict Moderate to Severe Steatosis in Obese Liver Donors

Martini¹,

Anty²,

Schneck³

et al. 2017

J Obes Chronic Dis

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Background: In the selection of marginal liver grafts most transplantation centers use a cut-off of 30% macrovesicular steatosis to define an acceptable risk of non-function. The aim of this prospective cohort study was to create a noninvasive model to predict >30% hepatic steatosis based on simple clinical and biochemical markers available at the time of potential liver-donor evaluation, to avoid futile and expensive procurement proceedings.

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Nonalcoholic fatty liver disease and liver transplantation

Cited by 131 publications

References 98 publications

Outcome After Liver Transplantation for NASH Cirrhosis

Outcome After Liver Transplantation for NASH Cirrhosis

Fast food diet mouse: novel small animal model of NASH with ballooning, progressive fibrosis, and high physiological fidelity to the human condition

A Simple Model to Predict Moderate to Severe Steatosis in Obese Liver Donors

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