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Titolo:
Development of nonalcoholic fatty liver disease after orthotopic liver transplantation for cryptogenic cirrhosis
Autore:
Contos, MJ; Cales, W; Sterling, RK; Luketic, VA; Shiffman, ML; Mills, AS; Fisher, RA; Ham, J; Sanyal, AJ;
Indirizzi:
Virginia Commonwealth Univ, Med Coll Virginia, Div Gastroenterol Hepatol Nutr, Dept Internal Med, Richmond, VA 23298 USA Virginia Commonwealth Univ Richmond VA USA 23298 , Richmond, VA 23298 USA Virginia Commonwealth Univ, Med Coll Virginia, Div Gastroenterol Hepatol Nutr, Dept Pathol, Richmond, VA 23298 USA Virginia Commonwealth Univ Richmond VA USA 23298 , Richmond, VA 23298 USA Virginia Commonwealth Univ, Med Coll Virginia, Div Gastroenterol Hepatol Nutr, Dept Surg, Richmond, VA 23298 USA Virginia Commonwealth Univ RichmondVA USA 23298 , Richmond, VA 23298 USA
Titolo Testata:
LIVER TRANSPLANTATION
fascicolo: 4, volume: 7, anno: 2001,
pagine: 363 - 373
SICI:
1527-6465(200104)7:4<363:DONFLD>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
METABOLIC SYNDROME; WEIGHT-LOSS; STEATOHEPATITIS NASH; INSULIN-RESISTANCE; CHRONIC HEPATITIS; CLINICAL ENTITY; NATURAL-HISTORY; OBESE PATIENTS; STEATOSIS; PREVALENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
46
Recensione:
Indirizzi per estratti:
Indirizzo: Sanyal, AJ Virginia Commonwealth Univ, Med Coll Virginia, Div Gastroenterol Hepatol Nutr, Dept Internal Med, Box 980711, Richmond, VA 23298 USA Virginia Commonwealth Univ Box 980711 Richmond VA USA 23298 USA
Citazione:
M.J. Contos et al., "Development of nonalcoholic fatty liver disease after orthotopic liver transplantation for cryptogenic cirrhosis", LIVER TRANS, 7(4), 2001, pp. 363-373

Abstract

Many subjects with cryptogenic cirrhosis have underlying nonalcoholic steatohepatitis (NASH), The natural history of NASH-related cryptogenic cirrhosis after orthotopic liver transplantation (OLT) is not well defined. A primarily retrospective study of patients with the clinical histological phenotype of NASH-related cirrhosis undergoing OLT was performed. Data were compared with 2 sets of age- and weight-matched controls with (1) primary biliary cirrhosis or primary sclerosing cholangitis or (2) alcoholic liver disease. After OLT, all patients were managed by a standard immunosuppressive protocol. Liver biopsies were performed at 6 and 12 months after OLT and at 1-to 2-year intervals thereafter, as well as when liver enzyme levels were elevated enough to warrant diagnostic biopsy. Twenty-seven subjects with cryptogenic cirrhosis and a clinical histological phenotype of NASH and 3 patients with a long-standing diagnosis of NASH before OLT were included. The 30-day perioperative mortality was 1 in 30 patients, During a median follow-up of 3.5 +/- 2.7 years, 2 additional patients died of sepsis, There was a time-dependent increase in the risk for allograft steatosis that approached100% by 5 years compared with only an approximately 25% incidence of steatosis in the control groups (P < .009, log-rank test). On multivariate analysis, only the cumulative steroid dose correlated with time to development of allograft steatosis, Three patients developed histological progression from hepatic steatosis to steatohepatitis, Of these, 1 patient developed progressive fibrosis. Four patients experienced at least 1 episode of acute cellular rejection; however, no patient developed chronic rejection or graft failure. In conclusion, nonalcoholic fatty liver disease occurs frequently after OLT in patients with the phenotype of NASH-related cirrhosis. Despite the frequent histological recurrence of disease, clinical outcomes are similar to those of other groups of patients undergoing OLT.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/04/20 alle ore 02:37:22