Equivalent survival following liver transplantation in patients with non-alcoholic steatohepatitis compared with patients with other liver diseases.

Academic Article

Abstract

  • BACKGROUND: Orthotopic liver transplantation (LT) in non-alcoholic steatohepatitis (NASH) is increasing in parallel with the obesity epidemic. METHODS: This study retrospectively reviewed the clinical outcomes of LTs in NASH (n = 129) and non-NASH (n = 775) aetiologies carried out at a single centre between 1999 and 2009. RESULTS: Rates of 1-, 3- and 5-year overall survival in NASH (90%, 88% and 85%, respectively) were comparable with those in non-NASH (92%, 86% and 80%, respectively) patients. Mortality within 4 months of LT was twice as high in NASH as in non-NASH patients (8.5% vs. 4.2%; P = 0.04). Compared with non-NASH patients, post-LT mortality in NASH patients was more commonly caused by infectious (38% vs. 26%; P < 0.05) or cardiac (19% vs. 7%; P < 0.05) aetiologies. Five-year survival was lower in NASH patients with a high-risk phenotype (age >60 years, body mass index >30 kg/m(2), with hypertension and diabetes) than in NASH patients without these characteristics (72% vs. 87%; P = 0.02). Subgroup analyses revealed that 5-year overall survival in NASH was equivalent to that in Laennec's cirrhosis (85% vs. 80%; P 0.87), but lower than that in cirrhosis of cryptogenic aetiology (85% vs. 96%; P = 0.04). CONCLUSIONS: Orthotopic LT in NASH was associated with increased early postoperative mortality, but 1-, 3- and 5-year overall survival rates were equivalent to those in non-NASH patients.
  • Published In

  • HPB  Journal
  • Keywords

  • Adult, Aged, Alabama, Cause of Death, Chi-Square Distribution, Fatty Liver, Female, Humans, Kaplan-Meier Estimate, Liver Diseases, Liver Transplantation, Male, Middle Aged, Multivariate Analysis, Non-alcoholic Fatty Liver Disease, Postoperative Complications, Proportional Hazards Models, Reoperation, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome
  • Digital Object Identifier (doi)

    Author List

  • Kennedy C; Redden D; Gray S; Eckhoff D; Massoud O; McGuire B; Alkurdi B; Bloomer J; DuBay DA
  • Start Page

  • 625
  • End Page

  • 634
  • Volume

  • 14
  • Issue

  • 9