Nafld and liver transplantation: current burden and expected challenges

Because of global epidemics of obesity and type 2 diabetes, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing both in Europe and USA becoming one of the most frequent causes of chronic liver disease and predictably, one of the leading causes of liver transplantation (LT) both for end-stage liver disease and hepatocellular carcinoma. For most transplant teams around the world this will raise many challenges in terms on pre- and post-transplant management. Here we review the multifaceted impact of NAFLD on liver transplantation and will discuss: (1) NAFLD as frequent cause of cryptogenic cirrhosis, end-stage chronic liver disease and hepatocellular carcinoma; (2) prevalence of NAFLD as an indication for LT both in Europe and US; (3) the impact of NAFLD on the donor pool; (4) the access of NAFLD patients to LT and their management on the waiting list in regard to metabolic, renal and vascular comorbidities; (5) the prevalence and consequences of post-transplant metabolic syndrome, recurrent and de novo NAFLD; (6) the alternative management and therapeutic options to improve the long-term outcomes with particular emphasis to the correction and control of metabolic comorbidities.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Review Source Type: research