Liver transplantation for non-alcoholic fatty liver disease: indications and post-transplant management

Author: Sara BATTISTELLA ¹ ; Francesca D’ARCANGELO ; Marco GRASSO ; Alberto ZANETTO ; Martina GAMBATO ; Giacomo GERMANI ; Marco SENZOLO ; Francesco Paolo RUSSO ; Patrizia BURRA
Author Information

1. Gastroenterology and Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, University of Padua, Padua, Italy
Publication Type:Review
From:Clinical and Molecular Hepatology 2023;29(Suppl):S286-S301
CountryRepublic of Korea
Language:English
Abstract: 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. NAFLDon-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.