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Multicenter Study
. 2024 Apr 15:15:1306091.
doi: 10.3389/fendo.2024.1306091. eCollection 2024.

Impact of the diagnosis of metabolic dysfunction-associated fatty liver disease and non-alcoholic fatty liver disease in patients undergoing liver transplantation for hepatocellular carcinoma

Ji-Qiao Zhu #  1 , Jia-Zong Liu #  1 , Shi-Wei Yang #  2 , Zhang-Yong Ren  1 , Xiao-Yong Ye  1 , Zhe Liu  1 , Xian-Liang Li  1 , Dong-Dong Han  2 , Qiang He  1
Affiliations
Multicenter Study

Impact of the diagnosis of metabolic dysfunction-associated fatty liver disease and non-alcoholic fatty liver disease in patients undergoing liver transplantation for hepatocellular carcinoma

Ji-Qiao Zhu et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: Whether the diagnosis of non-alcoholic fatty liver disease or metabolic dysfunction-associated fatty disease has a different impact on liver transplant recipients with hepatocellular carcinoma is not yet clear.

Methods: Data from a two-center retrospective cohort study were collected to compare and investigate the differences between non-alcoholic fatty liver disease and metabolic dysfunction-associated fatty liver disease in clinicopathologic parameters and prognosis among liver transplant recipients with hepatocellular carcinoma.

Results: A total of 268 liver transplant recipients with hepatocellular carcinoma were included. The prevalence among pre- and post-transplant metabolic dysfunction-associated fatty liver disease was 10.82% and 30.22%, while for non-alcoholic fatty liver disease, it was 7.09% and 26.87%, respectively. The clinicopathological parameters were similar between the two pre-transplant groups. In contrast, the post-transplant group with metabolic dysfunction-associated fatty liver disease exhibited a higher prevalence of diabetes mellitus and a greater body mass index. However, the other parameters were similar between the two post-transplant groups (p > 0.05). Factors such as the largest tumor size > 4 cm, microvascular invasion, lack of tumor capsule, post-transplant metabolic dysfunction-associated fatty liver disease, and decreased post-transplant lymphocyte percentage were related to an increased risk of recurrence.

Conclusion: In patients undergone liver transplantation for hepatocellular carcinoma, the diagnosis of metabolic dysfunction-associated fatty disease is more strongly associated with metabolic abnormalities than the diagnosis of non-alcoholic fatty liver disease and is an independent predictor of hepatocellular carcinoma recurrence.

Keywords: hepatocellular carcinoma; liver transplantation; metabolic dysfunction-associated fatty liver disease; non-alcoholic fatty liver disease; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overlap between pre- and post-transplant MAFLD and NAFLD. MAFLD, metabolic dysfunction-associated fatty liver disease; NAFLD, non-alcoholic fatty liver disease.
Figure 2
Figure 2
Comparison of TFS and OS between patients with MAFLD and NAFLD. TFS, tumor-free survival; OS, overall survival; MAFLD, metabolic dysfunction-associated fatty liver disease; NAFLD, non-alcoholic fatty liver disease.
Figure 3
Figure 3
Multivariate analysis of prognostic factors related to HCC recurrence. HCC, hepatocellular carcinoma; AFP, alpha-fetoprotein; NAFLD, non-alcoholic fatty liver disease; MAFLD, metabolic dysfunction-associated fatty liver disease; NLR, neutrophil-to-lymphocyte count ratio.
Figure 4
Figure 4
Comparison of TFS and OS between patients with and without MAFLD. TFS, tumor-free survival; OS, overall survival; MAFLD, metabolic dysfunction-associated fatty liver disease.
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