Prevalence and risk factors of steatosis after liver transplantation and patient outcomes
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
26707008
DOI
10.1002/lt.24393
Knihovny.cz E-resources
- MeSH
- Alkaline Phosphatase blood MeSH
- Biopsy MeSH
- Time Factors MeSH
- Diabetes Mellitus, Type 2 blood MeSH
- Adult MeSH
- Liver Cirrhosis blood MeSH
- Mycophenolic Acid administration & dosage MeSH
- Middle Aged MeSH
- Humans MeSH
- Multivariate Analysis MeSH
- Non-alcoholic Fatty Liver Disease epidemiology etiology MeSH
- Alcohol Drinking MeSH
- Prevalence MeSH
- Disease Progression MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Liver Transplantation adverse effects MeSH
- Triglycerides blood MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Alkaline Phosphatase MeSH
- Mycophenolic Acid MeSH
- Triglycerides MeSH
Steatosis occurs frequently after liver transplantation (LT). We aimed to determine the prevalence of steatosis in adult LT recipients, to determine the effects of significant (>33%; grades 2-3) steatosis on patient survival, and to identify risk factors for the development of significant steatosis and its effect on fibrosis progression. We retrospectively examined 2360 posttransplant biopsies of 548 LT recipients. Survival was compared between patients with significant steatosis and those with grades 0-1 steatosis. Patients with significant steatosis were compared to controls without steatosis (grade 0) for clinical and laboratory factors and fibrosis progression. Steatosis was found in 309 (56.4%) patients, including 93 (17.0%) patients with significant steatosis. Steatohepatitis (nonalcoholic fatty liver disease activity score ≥ 5) was diagnosed in 57 (10.4%) patients. The prevalence of steatosis increased from 30.3% at 1 year to 47.6% at 10 years after LT (P < 0.001). Survival times did not differ between groups (P = 0.29). On multivariate analysis of pretransplant factors and initial immunosuppression (IS), alcohol-induced cirrhosis (P < 0.001) and high body mass index (BMI; P = 0.002) were associated with the development of significant steatosis, whereas increased levels of alkaline phosphatase (P = 0.01) and mycophenolate mofetil given initially (P = 0.009) appeared to protect against significant steatosis. On multivariate analysis of posttransplant factors, high BMI (P < 0.001), serum triglycerides (P < 0.001), alcohol consumption (P = 0.005), and type 2 diabetes mellitus (P = 0.048) were associated with significant steatosis, whereas high creatinine (P = 0.02) appeared to protect against significant steatosis. Significant steatosis was not associated with a higher fibrosis stage (P = 0.62). Posttransplant steatosis affects 56.4% of LT recipients, and the prevalence increases with time after LT. Recipient factors and types of IS affect the risk for significant steatosis, which is not associated with a higher fibrosis stage or worse patient survival. Liver Transplantation 22 644-655 2016 AASLD.
Department of Biostatistics Institute for Clinical and Experimental Medicine Prague Czech Republic
Transplant Centre Institute for Clinical and Experimental Medicine Prague Czech Republic
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