Non-alcoholic fatty liver disease – a rapidly growing indication for liver transplantation in the modern world

• Main Authors: I. M. Iljinsky, O. M. Tsirulnikova
• Format: Article
• Language: Russian
• Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2019-10-01
• Series: Vestnik Transplantologii i Iskusstvennyh Organov
• Subjects: nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; liver transplantation
• Online Access: https://journal.transpl.ru/vtio/article/view/1072

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in many countries, involving about 25% of the population worldwide. This disease includes many genetic, metabolic, and environmental factors. It is closely associated with insulin resistance, metabolic syndrome, obesity, diabetes, and many other diseases. NAFLD is characterized by macrovesicular steatosis of the liver. In the natural course of NAFLD simple steatosis progresses to nonalcoholic steatohepatitis (NASH), fibrosis and ultimately, cirrhosis and hepatocellular carcinoma. Cirrhosis with Nash and hepatocellular carcinoma is an indication for liver transplantation. Obesity is a growing problem in liver transplant candidates. Cardiovascular complications related to metabolic syndrome and NASH recurrence in the transplanted liver may affect the outcome of surgery in these patients. The results after transplantation are similar to the results of liver transplantation for other indications, but cardiovascular complications are the main cause of death in patients with NASH after surgery.