Ali Canbay1, Jan-Peter Sowa1, Wing-Kin Syn2, Jürgen Treckmann3. 1. Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany. 2. Division of Gastroenterology and Hepatology, The Medical University of South Carolina, Charleston, SC, USA; Section of Gastroenterology, Ralph H. Johnson Veteran Affairs Medical Center, Charleston, SC, USA. 3. Department of General, Visceral, and Transplantation Surgery, University Hospital, University Duisburg-Essen, Essen, Germany.
Abstract
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a continuously increasing cause of chronic liver disease and a health burden in all populations affected by the obesity and metabolic syndrome pandemic. Cirrhotic alterations or hepatocellular carcinoma developing from NAFLD may require liver transplantation (LTx). METHODS: Current literature was screened for data on LTx in the setting of NAFLD. RESULTS: NAFLD-associated LTx is expected to increase in number and relevance during the next decade. NAFLD is part of the metabolic syndrome and thus connected to various metabolic alterations and comorbidities such as diabetes or hyperlipidemia. Moreover, NAFLD comprises an independent risk factor for cardiovascular and chronic kidney disease, which again are important risk factors for outcome of surgical interventions. Postoperative immunosuppression, possible steatosis of the liver graft, and a continued presence of metabolic alterations may lead to early recurrence of steatosis or even non-alcoholic steatohepatitis. Currently, no data are available on combined approaches of weight loss and LTx for NAFLD. CONCLUSION: Specific guidelines on how to manage NAFLD-associated LTx are lacking. This particular situation requires close monitoring of metabolic syndrome-associated comorbidities. NAFLD represents a novel challenge to established LTx procedures.
BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is a continuously increasing cause of chronic liver disease and a health burden in all populations affected by the obesity and metabolic syndrome pandemic. Cirrhotic alterations or hepatocellular carcinoma developing from NAFLD may require liver transplantation (LTx). METHODS: Current literature was screened for data on LTx in the setting of NAFLD. RESULTS: NAFLD-associated LTx is expected to increase in number and relevance during the next decade. NAFLD is part of the metabolic syndrome and thus connected to various metabolic alterations and comorbidities such as diabetes or hyperlipidemia. Moreover, NAFLD comprises an independent risk factor for cardiovascular and chronic kidney disease, which again are important risk factors for outcome of surgical interventions. Postoperative immunosuppression, possible steatosis of the liver graft, and a continued presence of metabolic alterations may lead to early recurrence of steatosis or even non-alcoholic steatohepatitis. Currently, no data are available on combined approaches of weight loss and LTx for NAFLD. CONCLUSION: Specific guidelines on how to manage NAFLD-associated LTx are lacking. This particular situation requires close monitoring of metabolic syndrome-associated comorbidities. NAFLD represents a novel challenge to established LTx procedures.
Authors: Alexander Wree; Martin Schlattjan; Lars P Bechmann; Thierry Claudel; Jan-Peter Sowa; Tatjana Stojakovic; Hubert Scharnagl; Harald Köfeler; Hideo A Baba; Guido Gerken; Ariel E Feldstein; Michael Trauner; Ali Canbay Journal: Metabolism Date: 2014-09-06 Impact factor: 8.694
Authors: Roger K Schindhelm; Jacqueline M Dekker; Giel Nijpels; Lex M Bouter; Coen D A Stehouwer; Robert J Heine; Michaela Diamant Journal: Atherosclerosis Date: 2006-05-08 Impact factor: 5.162
Authors: Austin L Spitzer; Oliver B Lao; André A S Dick; Ramasamy Bakthavatsalam; Jeffrey B Halldorson; Matthew M Yeh; Melissa P Upton; Jorge D Reyes; James D Perkins Journal: Liver Transpl Date: 2010-07 Impact factor: 5.799
Authors: M Emdin; C Passino; C Michelassi; F Titta; A L'abbate; L Donato; A Pompella; A Paolicchi Journal: Eur Heart J Date: 2001-10 Impact factor: 29.983
Authors: Bum J Park; Yoon J Kim; Dong H Kim; Won Kim; Yong J Jung; Jung H Yoon; Chung Y Kim; Young M Cho; Se H Kim; Kyoung B Lee; Ja J Jang; Hyo S Lee Journal: J Gastroenterol Hepatol Date: 2007-11-07 Impact factor: 4.029
Authors: Lars P Bechmann; Denis Zahn; Robert K Gieseler; Christian D Fingas; Guido Marquitan; Christoph Jochum; Guido Gerken; Scott L Friedman; Ali Canbay Journal: Hepatol Res Date: 2009-01-14 Impact factor: 4.288
Authors: M Shadab Siddiqui; Richard K Sterling; Velimir A Luketic; Puneet Puri; R Todd Stravitz; Iliana Bouneva; Sherry Boyett; Michael Fuchs; Carol Sargeant; G Russell Warnick; Shahrzad Grami; Arun J Sanyal Journal: Gastroenterology Date: 2013-08-21 Impact factor: 22.682
Authors: Ivana Mikolasevic; Tajana Filipec-Kanizaj; Maja Mijic; Ivan Jakopcic; Sandra Milic; Irena Hrstic; Nikola Sobocan; Davor Stimac; Patrizia Burra Journal: World J Gastroenterol Date: 2018-04-14 Impact factor: 5.742