Non-alcoholic fatty liver disease in liver transplant recipients: another story of 'seed and soil'

Autor: Laurent Spahr, Antoine Hadengue, Isabelle Morard, Olivier Guillaud, Emiliano Giostra, Jérôme Dumortier, Soraya Belbouab, Jean-Yves Scoazec, Laura Rubbia-Brandt, Olivier Boillot
Rok vydání: 2009
Předmět:
Male
medicine.medical_specialty
Alcoholic liver disease
Cirrhosis
Alcohol Drinking
medicine.medical_treatment
Biopsy
Alcohol Drinking/adverse effects/epidemiology
Liver transplantation
ddc:616.07
Gastroenterology
France/epidemiology
Statistics
Nonparametric
Liver disease
Switzerland/epidemiology
Recurrence
Risk Factors
Internal medicine
Prevalence
Medicine
Humans
Immunosuppressive Agents/administration & dosage
Retrospective Studies
ddc:616
Chi-Square Distribution
Hepatology
medicine.diagnostic_test
business.industry
Liver Diseases
Fatty liver
Middle Aged
medicine.disease
Liver Transplantation/ adverse effects
Liver Transplantation
Fatty Liver
Logistic Models
Liver Diseases/ surgery
Liver biopsy
Female
France
Steatohepatitis
Steatosis
business
Fatty Liver/diagnosis/epidemiology/ etiology
Immunosuppressive Agents
Switzerland
Zdroj: American Journal of Gastroenterology, Vol. 105, No 3 (2010) pp. 613-620
ISSN: 1572-0241
0002-9270
Popis: OBJECTIVES: Fatty liver disease is a potential long-term complication of liver transplantation (LT). We therefore aimed to determine the prevalence and risk factors of liver steatosis in a large population of adult post-LT patients. METHODS: We evaluated the clinical, biological, histological, and evolutive features of patients with a diagnosis of steatosis made at liver biopsy examination during post-LT follow-up. Risk factors were analyzed by univariate and multivariate analysis. RESULTS: In total, 1,596 liver biopsies from 599 patients were available. Recurrent liver disease was present in 178 patients. A histological diagnosis of steatosis was made in 131 (31.1%) of the remaining 421 patients (51.1% had normal liver tests): 53% had grade 1, 31% grade 2, and 16% grade 3 steatosis. Perisinusoidal fibrosis was present in 38 patients (29.0%). Histological lesions were consistent with the diagnosis of non-alcoholic steatohepatitis (NASH) in 5 patients (3.8%). At the end of follow-up, cirrhosis or extensive fibrosis was observed in 3 patients (2.25%). Multivariate analysis showed that seven factors (post-LT obesity, tacrolimus-based regimen, diabetes mellitus, hyperlipidemia, arterial hypertension, alcoholic cirrhosis as primary indication for LT, and pre-transplant liver graft steatosis) were risk factors for post-LT steatosis. When zero, one, two, three, four, five, and six factors were present, steatosis occurred in 6.0, 12.0, 22.1, 29.9, 65.5, 81.5, and 100.0%, respectively. CONCLUSIONS: Liver steatosis is a frequent late complication of LT; its development depends on a combination of host and graft factors. LT is therefore an interesting model to study the natural history and the determinants of liver steatosis.
Databáze: OpenAIRE
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