Liver Transplantation for Nonalcoholic Steatohepatitis

Pathophysiology of Recurrence and Clinical Challenges

Naga Swetha Samji, Rajanshu Verma, Krishna Chaitanya Keri, Ashwani K. Singal, Aijaz Ahmed, Mary Rinella, David Bernstein, Manal F. Abdelmalek, Sanjaya Satapathy

Research output: Contribution to journalReview article

Abstract

Nonalcoholic steatohepatitis is the fastest-growing indication for the liver transplant and a leading cause of hepatocellular carcinoma among patients listed for liver transplantation in the USA. Post-transplant nonalcoholic hepatic steatosis and steatohepatitis are frequent complications of liver transplantation. Nonalcoholic steatohepatitis poses a significant challenge in both pre- and post-transplant period due to its association with metabolic syndrome, coronary artery disease, chronic kidney disease, and obstructive sleep apnea. While optimal therapy is not yet available in the post-liver transplant setting, lifestyle interventions continue to remain as the mainstay of therapy for post-transplant nonalcoholic steatohepatitis. Early recognition with protocol biopsies and noninvasive modalities, along with modification of known risk factors, are the most effective methods to curtail the progression of nonalcoholic steatohepatitis in the absence of FDA-approved pharmacologic therapy.

Original languageEnglish (US)
JournalDigestive Diseases and Sciences
DOIs
StatePublished - Jan 1 2019

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Liver Transplantation
Transplants
Recurrence
Liver
Obstructive Sleep Apnea
Fatty Liver
Chronic Renal Insufficiency
Non-alcoholic Fatty Liver Disease
Life Style
Coronary Artery Disease
Hepatocellular Carcinoma
Therapeutics
Biopsy

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Cite this

Liver Transplantation for Nonalcoholic Steatohepatitis : Pathophysiology of Recurrence and Clinical Challenges. / Samji, Naga Swetha; Verma, Rajanshu; Keri, Krishna Chaitanya; Singal, Ashwani K.; Ahmed, Aijaz; Rinella, Mary; Bernstein, David; Abdelmalek, Manal F.; Satapathy, Sanjaya.

In: Digestive Diseases and Sciences, 01.01.2019.

Research output: Contribution to journalReview article

Samji, Naga Swetha ; Verma, Rajanshu ; Keri, Krishna Chaitanya ; Singal, Ashwani K. ; Ahmed, Aijaz ; Rinella, Mary ; Bernstein, David ; Abdelmalek, Manal F. ; Satapathy, Sanjaya. / Liver Transplantation for Nonalcoholic Steatohepatitis : Pathophysiology of Recurrence and Clinical Challenges. In: Digestive Diseases and Sciences. 2019.
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abstract = "Nonalcoholic steatohepatitis is the fastest-growing indication for the liver transplant and a leading cause of hepatocellular carcinoma among patients listed for liver transplantation in the USA. Post-transplant nonalcoholic hepatic steatosis and steatohepatitis are frequent complications of liver transplantation. Nonalcoholic steatohepatitis poses a significant challenge in both pre- and post-transplant period due to its association with metabolic syndrome, coronary artery disease, chronic kidney disease, and obstructive sleep apnea. While optimal therapy is not yet available in the post-liver transplant setting, lifestyle interventions continue to remain as the mainstay of therapy for post-transplant nonalcoholic steatohepatitis. Early recognition with protocol biopsies and noninvasive modalities, along with modification of known risk factors, are the most effective methods to curtail the progression of nonalcoholic steatohepatitis in the absence of FDA-approved pharmacologic therapy.",
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AU - Rinella, Mary

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