title: Liver transplantation in nonalcoholic steatohepatitis is associated with high mortality and post-transplant complications: a single-center experience.
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) with its progressive form nonalcoholic steatohepatitis (NASH) is the most common chronic liver disease in western countries which is associated with end-stage liver disease and hepatocellular carcinoma (HCC). This entity is a consistently increasing indication for transplantation. However, data about postsurgery outcome and complications are still limited.
  
  
  METHODS
  Records of 432 consecutive transplanted patients between October 2007 and January 2011 were investigated retrospectively. Forty transplants were performed due to NASH-induced cirrhosis. Perioperative courses and short- and long-term outcomes were analyzed.
  
  
  RESULTS
  The NAFLD population consisted of 16 women and 24 men with a mean age of 55 years. The median MELD score was 27 at the time of liver transplantion. BMI before surgery ranged from 21 to 45 (mean 31). Sixteen of the initial 40 patients are still alive. Patients with sustained obesity and features of the metabolic syndrome had a worse 1-year mortality rate of 42%.
  
  
  CONCLUSIONS
  A significant number of liver transplantations in our center was performed due to NASH; transplantation in this cohort was associated with high mortality and postoperative complications, most likely due to associated obesity and diabetes. Weight reduction prior to surgery may lead to a better outcome.
authors: Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Essen, Germany. matthias.heuer@uk-essen.de
authors: Matthias
authors: M
authors: Heuer
authors: Gernot M
authors: GM
authors: Kaiser
authors: Alisan
authors: A
authors: Kahraman
authors: Mark
authors: M
authors: Banysch
authors: Fuat H
authors: FH
authors: Saner
authors: Zoltan
authors: Z
authors: Mathé
authors: Guido
authors: G
authors: Gerken
authors: Andreas
authors: A
authors: Paul
authors: Ali
authors: A
authors: Canbay
authors: Jürgen W
authors: JW
authors: Treckmann
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology; D005234:Fatty Liver / Q000150:complications / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D055031:Primary Graft Dysfunction / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome