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The post-transplant course of patients undergoing liver transplantation for nonalcoholic steatohepatitis versus cryptogenic cirrhosis: a retrospective case-control study.
Eur J Gastroenterol Hepatol. 2017 Mar; 29(3):309-316.EJ

Abstract

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) can be considered the hepatic manifestation of the metabolic syndrome with nonalcoholic steatohepatitis (NASH) as its progressive form. With increasing prevalence of the metabolic syndrome, NASH cirrhosis is becoming a leading cause for liver transplantation. Some cases of orthotopic liver transplantation (OLT) due to cryptogenic cirrhosis (CC) might show typical features of NASH cirrhosis. Therefore, our aim was to assess recurrence of liver fibrosis in patients transplanted for NASH versus CC after OLT.

PATIENTS AND METHODS

Patients transplanted for CC or NASH between 1 January 2004 and 30 September 2015 were included. The histological NAFLD activity score and the NAFLD fibrosis score (NFS) were assessed.

RESULTS

In total, 15 and 12 patients underwent OLT because of NASH and CC, respectively. The case load for OLT because of NASH was constantly increasing (n=2 in 2004-2007 vs. n=9 in 2012-2015) whereas decreasing for CC (n=6 in 2004-2007 vs. n=2 in 2012-2015). Patient characteristics at OLT were similar, except for an older age and a higher BMI in NASH patients (59.1±2.2 vs. 51.8±2.9 years, P=0.05; 27.7±1.2 vs. 24.3±0.8 kg/m, P=0.035). Although post-OLT plasma lipid levels and incidence of de-novo hypertension, diabetes, and hyperlipidemia were similar between groups, the post-transplant NFS re-increased in the NASH group (but not in the CC: -0.1317 vs. -1.3645 at 12 months post-OLT, P=0.0400). Post-transplant survival was similar in NASH and CC patients.

CONCLUSION

According to the NFS, some NASH patients show recurrence of fibrosis as early as 6-12 months after OLT.

Authors+Show Affiliations

aDepartment of Surgery, Division of Transplantation bClinical Institute of Pathology cDepartment of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

27922486

Citation

Unger, Lukas W., et al. "The Post-transplant Course of Patients Undergoing Liver Transplantation for Nonalcoholic Steatohepatitis Versus Cryptogenic Cirrhosis: a Retrospective Case-control Study." European Journal of Gastroenterology & Hepatology, vol. 29, no. 3, 2017, pp. 309-316.
Unger LW, Herac M, Staufer K, et al. The post-transplant course of patients undergoing liver transplantation for nonalcoholic steatohepatitis versus cryptogenic cirrhosis: a retrospective case-control study. Eur J Gastroenterol Hepatol. 2017;29(3):309-316.
Unger, L. W., Herac, M., Staufer, K., Salat, A., Silberhumer, G., Hofmann, M., Trauner, M., Rasoul-Rockenschaub, S., Soliman, T., Reiberger, T., & Berlakovich, G. A. (2017). The post-transplant course of patients undergoing liver transplantation for nonalcoholic steatohepatitis versus cryptogenic cirrhosis: a retrospective case-control study. European Journal of Gastroenterology & Hepatology, 29(3), 309-316. https://doi.org/10.1097/MEG.0000000000000794
Unger LW, et al. The Post-transplant Course of Patients Undergoing Liver Transplantation for Nonalcoholic Steatohepatitis Versus Cryptogenic Cirrhosis: a Retrospective Case-control Study. Eur J Gastroenterol Hepatol. 2017;29(3):309-316. PubMed PMID: 27922486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The post-transplant course of patients undergoing liver transplantation for nonalcoholic steatohepatitis versus cryptogenic cirrhosis: a retrospective case-control study. AU - Unger,Lukas W, AU - Herac,Merima, AU - Staufer,Katharina, AU - Salat,Andreas, AU - Silberhumer,Gerd, AU - Hofmann,Michael, AU - Trauner,Michael, AU - Rasoul-Rockenschaub,Susanne, AU - Soliman,Thomas, AU - Reiberger,Thomas, AU - Berlakovich,Gabriela A, PY - 2016/12/7/pubmed PY - 2017/8/2/medline PY - 2016/12/7/entrez SP - 309 EP - 316 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 29 IS - 3 N2 - BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) can be considered the hepatic manifestation of the metabolic syndrome with nonalcoholic steatohepatitis (NASH) as its progressive form. With increasing prevalence of the metabolic syndrome, NASH cirrhosis is becoming a leading cause for liver transplantation. Some cases of orthotopic liver transplantation (OLT) due to cryptogenic cirrhosis (CC) might show typical features of NASH cirrhosis. Therefore, our aim was to assess recurrence of liver fibrosis in patients transplanted for NASH versus CC after OLT. PATIENTS AND METHODS: Patients transplanted for CC or NASH between 1 January 2004 and 30 September 2015 were included. The histological NAFLD activity score and the NAFLD fibrosis score (NFS) were assessed. RESULTS: In total, 15 and 12 patients underwent OLT because of NASH and CC, respectively. The case load for OLT because of NASH was constantly increasing (n=2 in 2004-2007 vs. n=9 in 2012-2015) whereas decreasing for CC (n=6 in 2004-2007 vs. n=2 in 2012-2015). Patient characteristics at OLT were similar, except for an older age and a higher BMI in NASH patients (59.1±2.2 vs. 51.8±2.9 years, P=0.05; 27.7±1.2 vs. 24.3±0.8 kg/m, P=0.035). Although post-OLT plasma lipid levels and incidence of de-novo hypertension, diabetes, and hyperlipidemia were similar between groups, the post-transplant NFS re-increased in the NASH group (but not in the CC: -0.1317 vs. -1.3645 at 12 months post-OLT, P=0.0400). Post-transplant survival was similar in NASH and CC patients. CONCLUSION: According to the NFS, some NASH patients show recurrence of fibrosis as early as 6-12 months after OLT. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/27922486/The_post_transplant_course_of_patients_undergoing_liver_transplantation_for_nonalcoholic_steatohepatitis_versus_cryptogenic_cirrhosis:_a_retrospective_case_control_study_ L2 - http://dx.doi.org/10.1097/MEG.0000000000000794 DB - PRIME DP - Unbound Medicine ER -