Table 3.
Recurrent, de novo NAFLD and advanced fibrosis after LT.
| Study | Population, N | Time after LT |
NAFLD**,# | NASH# | Fibrosis# | Comments |
|---|---|---|---|---|---|---|
| Contos 2001* | NASH and CC N = 27 |
1 year | 52% | 11% | ≥F3: 4% | Time-dependent risk of allograft steatosis: at 5 years 100% of assessable patients developed fatty liver. Recurrent NASH developed later than fatty liver alone. Cumulative dose of steroids correlated with time to NAFLD development. |
| Charlton 2001* | NASH N = 15 |
1 year | 60% | 33% | ≥F2: 33% | Cirrhosis developed in 12.5% of patients. 1 patient required re-transplantation for graft failure after 27 months. |
| Ong 2001* | CC N = 51 |
2 years | 25.4% | 16% | ≥F3:4% | Bridging fibrosis occurred in patients with post LT NASH. |
| Seo 2007§ | Non-NAFLD CLD N = 68 |
2 years | 18% | 9% | - | Increase of BMI of >10% was associated with post LT NAFLD |
| Bhagat 2009* | NASH N = 64 |
>6 months | - | 33% | - | No cirrhosis or re-transplantation because of recurrent disease. 24% of patients developed graft failure over follow-up. |
| Malik 2009* | NASH N = 98 |
5 years | - | 25% | - | Recurrent NASH did not adversely affect survival. 6 patients in NASH group were re-transplanted within 60 days after LT. |
| Yalamanchili 2010* | NASH and CC N = 257 |
5 years | 31% (45% in NASH cirrhosis; 23% in CC) |
4% | ≥F3: 5% at 5 years; 10% at 10 years |
Advanced fibrosis was more frequent amount those with post LT NASH (31%) than simple steatosis (6%) |
| Dumortier 2010§ | Non-NAFLD CLD N = 421 |
>6 months | 31% | 5.3% | ≥F3: 2.25% | Most of the patients (52%) had grade 1 steatosis. The evolution of NAFLD during follow-up was: regression (48%), stability (22%), progression (30%). PTMS and liver graft steatosis were independent predictors of de novo NAFLD. |
| Dureja 2011* | NASH or CC N = 88 |
1 year | 39% | 28% | ≥F2: 9% | Only 9% of recurrent NAFLD had NAS ≥5. NAFLD recurrence was associated with increased risk for CV disease and correlated with post-transplant BMI, post LT TG levels and corticosteroids dose at 6 month. |
| El Attrache 2012* | NASH and CC N = 83 |
1.5 years | - | 24% | ≥F3: 3.6% | The recurrence rate was significantly higher amoung patients with PTMS (34% vs. 13% in patients without MS). 3 patients were re-transplanted secondary to graft failure from NASH recurrence. |
| Kim 2014§ | Non-NAFLD CLD N = 156 |
>1 year | 27.1% | 6.7% | F2: 4.4% | Obesity and donor graft steatosis were independent predictors for post LT NAFLD. |
*
Recurrent NAFLD;
§
de novo NAFLD;
**
NAFLD includes NASH;
#
% of patients with the outcome.
LT, liver transplantation; PTMS, post-transplant metabolic syndrome.