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. 2024 Nov;38(11):e70039.
doi: 10.1111/ctr.70039.

Overweight Impacts Histological Disease Activity of De Novo Metabolic Dysfunction-Associated Steatotic Liver Disease After Liver Transplantation

Alejandro Campos-Murguia  1 , Lea Guetzlaff  1 , Emily Bosselmann  1 , Bastian Engel  1 , Björn Hartleben  2 , Heiner Wedemeyer  1 , Elmar Jaeckel  1   3 , Richard Taubert  1 , Katharina Luise Hupa-Breier  1
Affiliations

Overweight Impacts Histological Disease Activity of De Novo Metabolic Dysfunction-Associated Steatotic Liver Disease After Liver Transplantation

Alejandro Campos-Murguia et al. Clin Transplant. 2024 Nov.

Abstract

Background and aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is unknown. Furthermore, the impact of the distinct cardiometabolic risk factors on histological disease activity has not been assessed. We aimed to evaluate the prevalence of dnMASLD and the association between the cardiometabolic risk factors and histological disease activity.

Methods: We performed a retrospective single-center study in a LT cohort with indLbx and svLbx. Patients with NAFLD before LT were excluded.

Results: We analyzed 249 patients who underwent either svLbx or indLbx. Forty-eight (19.2%) had either dnMASLD (n = 26/249, 10.4%) or metabolic dysfunction associated steatohepatitis (dnMASH) (n = 22/249, 8.8%). Although dnMASLD/dnMASH was more frequent in indLbx (35.1%, p < 0.01), still 16.5% of patients with svLbx had dnMASLD/dnMASH. While overweight (p < 0.01) and diabetes (p = 0.01) were more frequent in patients with dnMASH, only overweight was associated with histological disease activity in the multivariate analysis. No impact of dnMASLD on the overall survival was observed.

Conclusion: While dnMASLD is more frequent in patients with indLBX, it also occurs in 16.5% of patients without signs of graft dysfunction. Overweight has the strongest impact on histological disease activity and should be monitored carefully after LT.

Keywords: fibrosis; metabolic dysfunction‐associated steatohepatitis; metabolic syndrome; nonalcoholic fatty liver disease; protocol biopsy.

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Conflict of interest statement

Katharina Hupa‐Breier received lecture fees from Gilead and Falk Pharma. Heiner Wedemeyer received lecture fees from Falk Pharma, Gore, Merz and Norgine and acts as a Principal Investigator for Falk Pharma. He received grants from Merz and Norgine. Elmar Jaeckel has received honoraria and travel support from Lilly GmbH and Boehringer Ingelheim. All other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart outlining the patient's selection process.
FIGURE 2
FIGURE 2
Metabolic dysfunctions and histological activity (NAS score). (a) Association between the type of metabolic dysfunction and the NAS score. (b) Association between the number of metabolic dysfunctions and the NAS score. (c) B coefficients of the multivariate analysis for the prediction of the NAS score. (d) Association between the type of metabolic dysfunction and the Ishak F score. (e) Association between the number of metabolic dysfunctions and the Ishak F score. (f) B coefficients of the multivariate analysis for the prediction of the Ishak F score. DM, diabetes mellitus; HTN, arterial hypertension; Oth. Met. Dysf, other metabolic dysfunctions; OW, overweight.
See this image and copyright information in PMC

References

    1. Riazi, Azhari H., Charette J. H., et al., “The Prevalence and Incidence of NAFLD Worldwide: A Systematic Review and Meta‐Analysis,” Lancet Gastroenterol Hepatol 7, no. 9 (2022): 851–861, 10.1016/S2468-1253(22)00165-0. - DOI - PubMed
    1. Wong R. J. and Singal A. K., “Trends in Liver Disease Etiology Among Adults Awaiting Liver Transplantation in the United States, 2014‐2019,” JAMA Network Open 3, no. 2 (2020): e1920294, 10.1001/jamanetworkopen.2019.20294. - DOI - PubMed
    1. Rinella M. E., Lazarus J. V., Ratziu V., et al., “A Multi‐Society Delphi Consensus Statement on New Fatty Liver Disease Nomenclature,” Journal of Hepatology 79, no. 6 (2023): 1542–1556, 10.1016/j.jhep.2023.06.003. - DOI - PubMed
    1. Allen A. M., Therneau T. M., Ahmed O. T., et al., “Clinical Course of Non‐alcoholic Fatty Liver Disease and the Implications for Clinical Trial Design,” Journal of Hepatology 77, no. 5 (2022): 1237–1245, 10.1016/j.jhep.2022.07.004. - DOI - PMC - PubMed
    1. Silva A. C., Nogueira P., and Machado M. V., “Hepatic Steatosis After Liver Transplantation: A Systematic Review and Meta‐analysis,” Liver Transplantation: Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 29, no. 4 (2023): 431–448, 10.1097/lvt.0000000000000060. - DOI - PubMed

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