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Outcomes of liver transplantation for NASH

March's issue of the Clinical Gastroenterology & Hepatology reviews outcomes after liver transplantation for nonalcoholic steatohepatitis.

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Little is known about outcomes of patients with nonalcoholic steatohepatitis (NASH) who receive liver transplants.

Dr Jingdong Li and colleagues performed a systematic review and meta-analysis to estimate post-transplant outcomes, survival times, and mortality from cardiovascular complications, sepsis, and graft failure in these patients.

The team searched PubMed and EMBASE, and Cochrane library and Web of Science databases for studies published through 2012 of patients who underwent liver transplantation for NASH or nonalcoholic fatty liver disease (NAFLD).

All original studies from single institutions that reported outcomes of patients with or without NASH after liver transplantation were considered.

Odds ratios were calculated for patients with NASH, compared with patients without NASH.

Patients with NASH were at lower risk of graft failure
Clinical Gastroenterology & Hepatology

The team identified 9 publications, on 717 patients with NASH and 3520 without, all of whom underwent liver transplantation.

Similar proportions of patients with and without NASH who received liver transplants survived for 1, 3, and 5 years.

The researchers observed that patients with NASH had a greater risk of death from cardiovascular complications after liver transplantation, and from sepsis.

However, the team found that patients with NASH were at lower risk of graft failure compared with patients without NASH.

Dr Li and team concludes, "Similar proportions of patients with and without NASH survive for 1, 3, and 5 years after liver transplantation."

"However, patients with NASH are more likely to die from cardiovascular complications or sepsis."

"More attention and careful consideration are therefore required in selecting patients with NASH for liver transplantation, along with aggressive management of cardiovascular complications and sepsis after transplantation."

Clin Gastroenterol Hepatol 2014: 12(3): 394-402.e1
24 February 2014

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