MASH Continues as a Significant Burden on Metabolic Health of Liver Recipients

Kinga Czarnecka; Paulina Czarnecka; Olga Tronina; Teresa Bączkowska; Magdalena Durlik

doi:10.1016/j.transproceed.2024.02.007

MASH Continues as a Significant Burden on Metabolic Health of Liver Recipients

Transplant Proc. 2024 Feb 24:S0041-1345(24)00133-7. doi: 10.1016/j.transproceed.2024.02.007. Online ahead of print.

Authors

Kinga Czarnecka¹, Paulina Czarnecka², Olga Tronina², Teresa Bączkowska², Magdalena Durlik²

Affiliations

¹ Department of Transplant Medicine, Immunology, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland. Electronic address: kinga.czarnecka@wum.edu.pl.
² Department of Transplant Medicine, Immunology, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.

PMID: 38403537
DOI: 10.1016/j.transproceed.2024.02.007

Abstract

Background: Metabolic complications are a recognized health concern in liver transplant recipients that result in inferior patient-reported outcomes. Patients with MASH are known to be disproportionately affected by metabolic diseases compared to other indications for transplantation.

Purpose: The aim of this study was to investigate the incidence of metabolic abnormalities in liver recipients with specific focus on differences between patients transplanted for MASH and non-MASH-causes.

Patients and methods: An observational, monocentric, and retrospective analysis was performed. Patients who received a cadaveric-donor-liver transplant between 2010 and 2019 were eligible.

Results: 282 patients were enrolled with a median age of 52 years (66.7% males). Metabolic dysfunction-associated steatohepatitis (MASH) led to liver transplant in 8.2% of cases. De-novo metabolic syndrome was diagnosed in 36% of the study population. Patients that underwent transplant owing to MASH showed significantly higher incidence of metabolic complications in both pre- and post-transplant period. Considerable differences were noted in the pattern of weight gain between patients transplanted for MASH and non-MASH patients. The MASH etiology (OR: 5.5; 95% CI: 1.624-22.868; P = .010), higher BMI at 1-year post-transplant (OR: 1.321; 95% CI: 1.214-1.449; P = <.001), and older age at transplant (OR: 1.038; 95% CI: 1.006-1.074; P = .022) were independently associated with new-onset metabolic syndrome in liver recipients.

Conclusion: Metabolic complications were prevalent in liver recipients. Liver recipients with underlying MASH significantly surpassed patients transplanted for other indications in terms of metabolic complications incidence and demonstrated an unfavorable trajectory of weight gain post-transplant.