Table 1.
Summary of studies that evaluated post-transplant nonalcoholic fatty liver disease and metabolic syndrome
| Ref. | Patient (n) | Follow up period | Outcomes post OLT n (%) | Metabolic syndrome post OLT |
| Kim et al[25] | 8 | 15 mo | 5/8 (63) → NAFL in 4 mo | BMI was higher in patients that developed steatosis |
| 1/8 (13) → NASH in 6 wk | Hyperlipidemia was observed in 5 patients who developed steatosis | |||
| No cirrhosis within the follow up period | ||||
| Contos et al[22] | 30 | > 4 yr | 4/27 (15) → NAFL in 6 mo | BMI and steroid use were higher in patients that developed steatosis |
| 1/27 (4) → NASH in 1 yr | DM prevalence was higher post OLT | |||
| 2/27 (7) → NASH in 3 yr | ||||
| 3/27 (11) → NASH in > 4 yr | ||||
| 1/30 (3) → cirrhosis, no time range was specified | ||||
| Charlton et al[57] | 31 | > 4 yr | 9/15 (60) → NAFL in 4 mo | MetS was observed more in the post-transplant setting |
| 2/15 (13) → NASH in 4 mo | No detailed reports on MetS components | |||
| 4/15 (27) → NASH in 1 yr | ||||
| 5/15 (33) → NASH in 2 yr | ||||
| 3/15 (20) → fibrosis < 1 yr | ||||
| 5/15 (33) → cirrhosis in > 4 yr | ||||
| Ayata et al[58] | 9 | 2 yr | Didn’t report steatosis or cirrhosis | No detailed report on post OLT metabolic syndrome |
| 2/9 (22) → NASH in 2 yr | ||||
| Seo et al[7] | 68 | > 4 yr | 12/68 (18) → NAFL, no time range was specified | MetS was higher in post OLT |
| BMI increased in 35% | ||||
| HTN developed in 69% | ||||
| 6/68 (9) → NASH, no time range was specified | DM was developed in 38% | |||
| Did not report cirrhosis | Hypertriglyceridemia in 25% | |||
| Malik et al[59] | 98 | Around 2 yr | 36/79 (45) → NAFL in 1 yr | MetS was higher post OLT and |
| (461 d) | BMI increased post OLT | |||
| 19/79 (24) → NASH in < 2 yr | HTN developed more frequently post OLT | |||
| DM was higher post OLT compared to pre-transplant period | ||||
| 14/79 (18) in < 2 yr | Hypertriglyceridemia was higher in post OLT setting | |||
| Bhagat et al[21] | 71 | 4 yr | Didn’t report steatosis | BMI increased in 17% |
| HTN developed in 35% | ||||
| 21/64 (33) → NASH in 6 mo | DM was developed in 16% | |||
| No cirrhosis in 4 yr | Hypertriglyceridemia in 18% | |||
| Yalamanchili et al[60] | 227 | 20 yr | 8.2% → NAFL in 1 yr | BMI increased post OLT and statistically significant compared to pre transplant BMI |
| 13.6% → in 2 yr | HTN developed in 52% | |||
| 25% → NAFL in 5 yr | DM developed in 36% | |||
| 33% → NAFL in 10 yr | ||||
| 6% → NASH 20 yr | ||||
| 5% → cirrhosis in 5 yr | ||||
| 10% → cirrhosis in 10 yr | ||||
| Finkenstedt et al[20] | 237 | 5 yr | 11.6% → NAFL in 1 yr | BMI was higher in patients with steatosis 28.7 compared to those without 25.4 (P = 0.005) |
| 27.5% → NAFL in 3 yr | ||||
| 32.6% → NAFL in 5 yr | DM was higher in patients who developed steatosis | |||
| No biopsies, no report on NASH | HTN development was not different between groups | |||
| No cirrhosis by imaging in 5 yr | Hypertriglyceridemia did not show difference |
BMI: Body mass index; MetS: Metabolic syndrome; DM: Diabetes mellitus; HTN: Hypertension; NAFL: Nonalcoholic fatty liver (steatosis); NASH: Nonalcoholic steatohepatitis; OLT: Orthotopic liver transplantation.