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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

Rivista di Gastroenterologia, Nutrizione e Dietetica


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Minerva Gastroenterologica e Dietologica 2017 Dec 15

DOI: 10.23736/S1121-421X.17.02467-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Liver transplantation for non-alcoholic fatty liver disease

Giacomo GERMANI , Chiara BECCHETTI

Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy


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Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome (MS) [1], and it is defined by the presence of steatosis in >5% of hepatocytes, according to histological analysis or detected by specific proton density fat fraction obtained MRI. The term NAFLD covers two pathologically distinct conditions: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), which can have similar clinical presentation, but with different prognosis. Both conditions can lastly lead to the development of cirrhosis. End stage liver-disease and hepatocellular carcinoma (HCC) represent the two standard indications for liver transplantation (LT) in patients affected by NAFLD [2]. Despite the evolution to end stage liver disease occur in 15-20% of NASH cases [3, 4], the absolute number of LT performed for NAFLD is dramatically increased in the last decade. Between 2004 and 2013 new waitlist registrants for NAFLD as indication increased from 804 to 2174, becoming rapidly the second most common indication for liver transplantation in the United States [5]. During the same period, indications to LT such as hepatitis C virus (HCV)-related and alcohol-related cirrhosis increased only by 14% and 45% respectively [6-8]. This review will focus on the management before and after LT for patients with NAFLD, with particular interest to comorbidities and outcomes.

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Publication History

Article first published online: December 15, 2017
Manuscript accepted: December 14, 2017
Manuscript received: December 14, 2017

Per citare questo articolo

Germani G, Becchetti C. Liver transplantation for non-alcoholic fatty liver disease. Minerva Gastroenterol Dietol 2017 Dec 15. DOI: 10.23736/S1121-421X.17.02467-9

Corresponding author e-mail

germani.giacomo@gmail.com