Article ; Online: Nonalcoholic steatohepatitis recurrence and rate of fibrosis progression following liver transplantation.
European journal of gastroenterology & hepatology
2017 Volume 29, Issue 4, Page(s) 481–487
Abstract: Background: Nonalcoholic steatohepatitis (NASH) is known to recur following liver transplantation (LT). Metabolic risk factors increase with immunosuppression. However, the rate of fibrosis progression following LT for NASH while on immunosuppression is ...
| Abstract | Background: Nonalcoholic steatohepatitis (NASH) is known to recur following liver transplantation (LT). Metabolic risk factors increase with immunosuppression. However, the rate of fibrosis progression following LT for NASH while on immunosuppression is less clear. Aim: The incidences of steatosis, NASH, and fibrosis following LT for NASH were quantified and compared with those transplanted for alcoholic liver disease (ALD). Patients and methods: Records of all NASH patients and 1 : 2 match with ALD transplant recipients between 2001 and 2006 were reviewed retrospectively. Patients without liver biopsies beyond 2 months following LT were excluded. Results: NASH patients (n=77) were older (P=0.0006) and less likely male (P<0.001) than ALD patients (n=108). The incidence of steatosis, NASH, and fibrosis stage increased at 1, 3, and 5 years in both groups. Although steatosis and nonalcoholic fatty liver disease activity scores were higher, fibrosis was lower in NASH compared with ALD (0.43 vs. 1.0 stage/year; P=0.0045). The incremental increase in the rate of fibrosis was faster in the first year compared with 4-5 years (0.8 vs. 0.04 stage/year) following LT. The rate of fibrosis progression during 4-5 years was decreased in NASH compared with ALD recipients (0.04 vs. 0.33 stage/year; P=0.015). NASH etiology was associated with reduced rate of fibrosis progression (odds ratio=0.67) on multivariate analysis. Conclusion: Despite having more steatosis and inflammation, progression of fibrosis was slower in NASH compared with ALD recipients. Fibrosis progression slows with time following LT on immunosuppression and approximates the pretransplant progression rate by year 5. |
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| MeSH term(s) | Aged ; Biopsy ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Immunosuppression/methods ; Kaplan-Meier Estimate ; Liver/pathology ; Liver Cirrhosis/etiology ; Liver Cirrhosis/pathology ; Liver Diseases, Alcoholic/complications ; Liver Diseases, Alcoholic/surgery ; Liver Transplantation ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/pathology ; Non-alcoholic Fatty Liver Disease/surgery ; Recurrence ; Retrospective Studies ; Severity of Illness Index |
| Language | English |
| Publishing date | 2017-04 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 1034239-4 |
| ISSN | 1473-5687 ; 0954-691X |
| ISSN (online) | 1473-5687 |
| ISSN | 0954-691X |
| DOI | 10.1097/MEG.0000000000000820 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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