Histologically proven non-alcoholic fatty liver disease and clinically related factors in recipients after liver transplantation

Clin Transplant. 2014 May;28(5):521-9. doi: 10.1111/ctr.12343. Epub 2014 Apr 16.

Abstract

Non-alcoholic fatty liver disease (NAFLD) affects a substantial proportion of the world population, and its prevalence has been increasing. The study was aimed at evaluating the prevalence and peri-transplant risk factors for post-liver transplantation (LT) NAFLD. A retrospective review was performed for adult recipients who underwent late protocol biopsy (>1 yr after LT) between August 2010 and December 2012. Hepatic steatosis was reviewed and graded by hepatopathologists, and the peri-transplant factors were analyzed for relationships to histologically proven NAFLD. Total 166 biopsies had been performed in 156 recipients. NAFLD was present in 27.1% at a mean period of 35.4 months between LT and biopsy, moderate and severe steatosis (≥33%) consisted of 28.9%. In multivariate analysis, pre-LT alcoholic cirrhosis (odds ratio [OR] 8.031, p = 0.003), obesity at biopsy (OR 3.873, p = 0.001), and preexisting donor graft steatosis (OR 3.147, p = 0.022) were significant risk factors for post-LT NAFLD. In conclusion, NAFLD represented a considerable portion of recipients, but this prevalence was not higher than those for general population. Three risk factors were significantly related to post-LT NAFLD, and recipients with those factors should be monitored for NAFLD. Furthermore, possible progression to non-alcoholic steatohepatitis (NASH) or fibrosis and metabolic syndrome should be considered in future studies.

Keywords: biopsy; hepatic steatosis; histology; steatohepatitis; steatosis; transplant.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Disease Progression
  • Female
  • Fibrosis / epidemiology*
  • Fibrosis / etiology
  • Fibrosis / pathology
  • Follow-Up Studies
  • Humans
  • Liver Diseases / complications*
  • Liver Diseases / surgery
  • Liver Transplantation / adverse effects*
  • Male
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / etiology
  • Metabolic Syndrome / pathology
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / epidemiology*
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / pathology
  • Odds Ratio
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Prevalence
  • Prognosis
  • Recurrence
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Young Adult