Nonalcoholic Fatty Liver Disease in Living Donor Liver Transplant Recipients: A Histology-Based Study.

Content Provider	Europe PMC
Author	Choudhary, Narendra S. Saraf, Neeraj Dhampalwar, Swapnil Mishra, Saurabh Gautam, Dheeraj Lipi, Lipika Rastogi, Amit Bhangui, Prashant Chaudhary, Rohan J. Gupta, Ankur Yadav, Kamal Soin, Arvinder S.
Copyright Year	2022
Abstract	Background Recurrent or de novo nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are common after liver transplantation (LT) and may be associated with rapid progression to fibrosis; however, there is limited data in this regard after living donor liver transplantation (LDLT). Material and methods This is a retrospective study at a high volume LDLT center of all liver biopsies performed in patients with post-transplant NAFLD diagnosed on ultrasound of the abdomen. Liver biopsy was indicated for raised transaminases and/or high liver stiffness on TE. The association between these prebiopsy parameters and inflammation and fibrosis on histology was analyzed. Data are shown as mean ± standard deviation or median (25–75 interquartile range). Results The study cohort consisted of 31 males and 3 females, aged 43 ± 10 years. The LT to liver biopsy interval was 44 (28–68) months. The prebiopsy AST and ALT were 71 (38–119) and 66 (50–156), respectively. The histology suggested no nonalcoholic steatohepatitis (NASH) in 7 (20%), borderline NASH in 15 (44%), and NASH in 12 (35%) patients. A total of 15 patients (44%) had stage 1 or stage 2 fibrosis. The proportion of patients having fibrosis was significantly higher in patients with NASH (83%) compared to patients with borderline NASH (33%) or no NASH (none had fibrosis, P = 0.001). Among 18 patients who underwent TE (on FibroScan), liver stiffness was significantly higher in patients with fibrosis [18.1 (9.7–22.5)] than in those without fibrosis [9.7 (4.0–12.7); P = 0.043]. Conclusion Over a third of the LDLT recipients with post-transplant NAFLD developed NASH, and nearly half, borderline NASH 3–5 years after transplant. Most with established NASH also had fibrosis on histology. Prevention of risk factors and early diagnosis is warranted in these patients.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9500106&blobtype=pdf
ISSN	09736883
Volume Number	12
DOI	10.1016/j.jceh.2022.04.012
PubMed Central reference number	PMC9500106
Issue Number	5
PubMed reference number	36157151
Journal	Journal of Clinical and Experimental Hepatology [J Clin Exp Hepatol]
e-ISSN	22133453
Language	English
Publisher	Elsevier
Publisher Date	2022-05-05
Access Restriction	Open
Rights License	© 2022 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.
Subject Keyword	NAFLD fibrosis liver stiffness measurement vibration controlled transient elastography liver enzymes CVD, cardiovascular disease LDLT, living donor liver transplantation LSM, liver stiffness measurements LT, liver transplantation NAFLD, nonalcoholic fatty liver disease NASH, nonalcoholic steatohepatitis TE, transient elastography
Content Type	Text
Resource Type	Article
Subject	Hepatology