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HERO ID
7280537
Reference Type
Journal Article
Subtype
Review
Title
Nonalcoholic Steatohepatitis After Liver Transplantation
Author(s)
Cotter, TG; Charlton, M
Year
2020
Volume
26
Issue
1
Page Numbers
141-159
Language
English
PMID
31610081
DOI
10.1002/lt.25657
Web of Science Id
WOS:000498242100001
Abstract
Currently, nonalcoholic steatohepatitis (NASH) is the second leading indication for liver transplantation (LT), behind alcohol-related liver disease. After transplant, both recurrent and de novo nonalcoholic fatty liver disease are common; however, recurrence rates of NASH and advanced fibrosis are low. Identification of high-risk groups and optimizing treatment of metabolic comorbidities both before and after LT is paramount to maintaining a healthy allograft, especially with the additional consequences of longterm immunosuppression. In addition, NASH LT recipients are at an increased risk of cardiovascular events and malignancy, and their condition warrants a tailored approach to management. The optimal approach to NASH LT recipients including metabolic comorbidities management, tailored immunosuppression, the role of bariatric surgery, and nutritional and pharmacotherapy of NASH are discussed in this review. Overall, aggressive management of metabolic syndrome after LT via medical and surgical modalities and a minimalist approach to immunosuppression is advised.
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