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NAFLD and liver transplantation: Current burden and expected challenges
Raluca Pais1, A Sidney Barritt2, Yvon Calmus1
1Service Hépatogastroentérologie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière - Université Pierre et Marie Curie, Paris, France; UMR_S 938, INSERM - CDR Saint Antoine, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
Journal of Hepatology
|August 4, 2016
Summary
Non-alcoholic fatty liver disease (NAFLD) is a growing cause of liver transplants due to obesity and diabetes. Managing NAFLD patients before and after liver transplantation presents significant challenges for medical teams.
Area of Science:
- Hepatology
- Transplantation Medicine
- Metabolic Diseases
Background:
- Increasing global rates of obesity and type 2 diabetes are driving a rise in non-alcoholic fatty liver disease (NAFLD).
- NAFLD is becoming a leading cause of chronic liver disease, end-stage liver disease, hepatocellular carcinoma, and liver transplantation in Europe and the US.
- The growing prevalence of NAFLD poses significant pre- and post-transplant management challenges for liver transplant teams worldwide.
Approach:
- This review examines the comprehensive impact of NAFLD on liver transplantation.
- It discusses NAFLD's role in cryptogenic cirrhosis, end-stage liver disease, and hepatocellular carcinoma.
- The review analyzes NAFLD prevalence as a liver transplant indication, its effect on the donor pool, and patient access and waiting list management.
Key Points:
- NAFLD is a significant driver of liver transplants, necessitating careful management of comorbidities like metabolic syndrome, renal, and vascular issues.
- Post-transplant, metabolic syndrome, and recurrent or de novo NAFLD are prevalent, impacting long-term outcomes.
- Effective management strategies focus on controlling metabolic comorbidities to improve patient prognosis.
Conclusions:
- Addressing the rising burden of NAFLD in liver transplantation requires a multifaceted approach.
- Optimizing pre- and post-transplant care, particularly metabolic control, is crucial for improving patient survival and outcomes.
- Further research into alternative management and therapeutic options is needed to enhance long-term success rates in liver transplant recipients with NAFLD.
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