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Review
. 2023 Feb;29(Suppl):S286-S301.
doi: 10.3350/cmh.2022.0392. Epub 2022 Dec 28.

Liver transplantation for non-alcoholic fatty liver disease: indications and post-transplant management

Sara Battistella  1 , Francesca D'Arcangelo  1 , Marco Grasso  1 , Alberto Zanetto  1 , Martina Gambato  1 , Giacomo Germani  1 , Marco Senzolo  1 , Francesco Paolo Russo  1 , Patrizia Burra  1
Affiliations
Review

Liver transplantation for non-alcoholic fatty liver disease: indications and post-transplant management

Sara Battistella et al. Clin Mol Hepatol. 2023 Feb.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is currently the fastest growing indication to liver transplantation (LT) in Western Countries, both for end stage liver disease and hepatocellular carcinoma. NAFLD/non-alcoholic steatohepatitis (NASH) is often expression of a systemic metabolic syndrome; therefore, NAFLD/NASH patients require a multidisciplinary approach for a proper pre-surgical evaluation, which is important to achieve a post-transplant outcome comparable to that of other indications to LT. NAFLD/NASH patients are also at higher risk of post-transplant cardiovascular events, diabetes, dyslipidemia, obesity, renal impairment and recurrent NASH. Lifestyle modifications, included diet and physical activity, are key to improve survival and quality of life after transplantation. A tailored immunosuppressive regimen may be proposed in selected patients. Development of new drugs for the treatment of recurrent NASH is awaited.

Keywords: Cardiovascular risk; Liver transplantation; Metabolic syndrome; NAFLD; NASH.

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Conflict of interest statement

Conflicts of Interest

The authors have no conflicts to disclose.

Figures

Figure 1.
Figure 1.
Management of NAFLD in the liver transplant setting. NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; CV, cardiovascular.
Figure 2.
Figure 2.
Management of NAFLD in the liver transplant setting. NAFLD, non-alcoholic fatty liver disease; CV, cardiovascular; ECG, electrocardiogram; US, ultrasound; CHD, coronary heart disease; SE, stress echocardiography; cardiac PET, cardiac positron emission tomography; CCTA, coronary computed tomography angiography; ICA, invasive coronary angiography.
See this image and copyright information in PMC

Comment in

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