Evolving aspects of liver transplantation for nonalcoholic steatohepatitis

Michael Charlton

Research output: Contribution to journalReview article

42 Scopus citations

Abstract

Purpose of review: Nonalcoholic steatohepatitis (NASH), obesity, and the metabolic syndrome are highly prevalent. NASH, a rare indication for liver transplantation in the early 1990s, is now the third most common indication. This review considers key aspects of the liver transplantation for NASH. Recent findings: NASH is one consequence of obesity, almost always occurring in the context of metabolic syndrome and oxidative stress. Recurrence of NASH can be severe. The components of metabolic syndrome are often exacerbated following liver transplantation by factors such as immunosuppression, and are important predictors of patient morbidity and mortality. Many aspects of the metabolic syndrome are modifiable. The roles bariatric surgery, nutritional and pharmacotherapy of NASH, and the impact of established and new immunosuppressive agents have recently evolved. Summary: A nuanced approach is needed in management of obesity, metabolic syndrome, and immunosuppression in liver transplant recipients.

Original languageEnglish (US)
Pages (from-to)251-258
Number of pages8
JournalCurrent opinion in organ transplantation
Volume18
Issue number3
DOIs
StatePublished - Jun 1 2013

Keywords

  • Liver transplantation
  • Metabolic syndrome
  • NASH
  • Obesity

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation

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