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Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease.
Liver Transpl. 2009 Dec; 15(12):1814-20.LT

Abstract

Nonalcoholic steatohepatitis (NASH) is becoming a common cause of liver cirrhosis requiring liver transplantation (LT). Cardiovascular complications related to metabolic syndrome and NASH recurrence in the transplanted liver may affect the outcome of LT in these patients. We compared the outcomes of LT for NASH cirrhosis and alcoholic cirrhosis (ETOH) in a large transplant center. A retrospective chart review was performed for all patients who underwent LT for cryptogenic cirrhosis with the NASH phenotype (the NASH group) or ETOH (the ETOH group) at the University of Miami from January 1997 to January 2007. There was no significant difference in survival between the NASH and ETOH groups, despite a trend toward lower survival in the former (P = 0.1699). Sepsis was the leading cause of posttransplant death in both groups, and it was followed by cardiovascular causes in the NASH group (26% versus 7% in the ETOH group, P = 0.21) and malignancies in the ETOH group (29% versus 0% in the NASH group, P = 0.024). Recurrent steatohepatitis (33% versus 0%, P < 0.0001) and acute rejection (41% versus 23%, P < 0.023) were significantly more frequent in the NASH group than in the ETOH group. There was no difference in graft failure between the groups (24% in the NASH group versus 18% in the ETOH group, P = 0.3973). In conclusion, despite a numerical trend favoring the ETOH group, there were no statistically significant differences in posttransplant survival and cardiovascular mortality between the NASH and ETOH groups. Acute rejection and recurrent steatohepatitis were significantly more frequent in the NASH group but did not lead to higher rates of retransplantation.

Authors+Show Affiliations

Center for Liver Diseases, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA. visbhagat@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19938128

Citation

Bhagat, Vishal, et al. "Outcomes of Liver Transplantation in Patients With Cirrhosis Due to Nonalcoholic Steatohepatitis Versus Patients With Cirrhosis Due to Alcoholic Liver Disease." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 15, no. 12, 2009, pp. 1814-20.
Bhagat V, Mindikoglu AL, Nudo CG, et al. Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease. Liver Transpl. 2009;15(12):1814-20.
Bhagat, V., Mindikoglu, A. L., Nudo, C. G., Schiff, E. R., Tzakis, A., & Regev, A. (2009). Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 15(12), 1814-20. https://doi.org/10.1002/lt.21927
Bhagat V, et al. Outcomes of Liver Transplantation in Patients With Cirrhosis Due to Nonalcoholic Steatohepatitis Versus Patients With Cirrhosis Due to Alcoholic Liver Disease. Liver Transpl. 2009;15(12):1814-20. PubMed PMID: 19938128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease. AU - Bhagat,Vishal, AU - Mindikoglu,Ayse L, AU - Nudo,Carmine G, AU - Schiff,Eugene R, AU - Tzakis,Andreas, AU - Regev,Arie, PY - 2009/11/26/entrez PY - 2009/11/26/pubmed PY - 2010/1/29/medline SP - 1814 EP - 20 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl. VL - 15 IS - 12 N2 - Nonalcoholic steatohepatitis (NASH) is becoming a common cause of liver cirrhosis requiring liver transplantation (LT). Cardiovascular complications related to metabolic syndrome and NASH recurrence in the transplanted liver may affect the outcome of LT in these patients. We compared the outcomes of LT for NASH cirrhosis and alcoholic cirrhosis (ETOH) in a large transplant center. A retrospective chart review was performed for all patients who underwent LT for cryptogenic cirrhosis with the NASH phenotype (the NASH group) or ETOH (the ETOH group) at the University of Miami from January 1997 to January 2007. There was no significant difference in survival between the NASH and ETOH groups, despite a trend toward lower survival in the former (P = 0.1699). Sepsis was the leading cause of posttransplant death in both groups, and it was followed by cardiovascular causes in the NASH group (26% versus 7% in the ETOH group, P = 0.21) and malignancies in the ETOH group (29% versus 0% in the NASH group, P = 0.024). Recurrent steatohepatitis (33% versus 0%, P < 0.0001) and acute rejection (41% versus 23%, P < 0.023) were significantly more frequent in the NASH group than in the ETOH group. There was no difference in graft failure between the groups (24% in the NASH group versus 18% in the ETOH group, P = 0.3973). In conclusion, despite a numerical trend favoring the ETOH group, there were no statistically significant differences in posttransplant survival and cardiovascular mortality between the NASH and ETOH groups. Acute rejection and recurrent steatohepatitis were significantly more frequent in the NASH group but did not lead to higher rates of retransplantation. SN - 1527-6473 UR - https://www.unboundmedicine.com/medline/citation/19938128/Outcomes_of_liver_transplantation_in_patients_with_cirrhosis_due_to_nonalcoholic_steatohepatitis_versus_patients_with_cirrhosis_due_to_alcoholic_liver_disease_ L2 - https://doi.org/10.1002/lt.21927 DB - PRIME DP - Unbound Medicine ER -