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KMID : 1040620230290000286
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Clinical and Molecular Hepatology
2023 Volume.29 No. 0 p.286 ~ p.301
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Liver transplantation for non-alcoholic fatty liver disease: indications and post-transplant management
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Sara Battistella
Francesca D′Arcangelo
Marco Grasso
Alberto Zanetto
Martina Gambato
Kim Hyun-Jin
Marco Senzolo
Francesco Paolo Russo
Patrizia Burra
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Abstract
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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.
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KEYWORD
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NAFLD, NASH, Liver transplantation, Cardiovascular risk, Metabolic syndrome
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