title: Living donor liver transplantation for non-alcoholic steatohepatitis: A single center experience.
abstract: OBJECTIVE
  The number of patients referred for liver transplantation (LT) with non-alcoholic steatohepatitis (NASH) continues to increase, but information about living donor liver transplantation (LDLT) for NASH is scarce. We conducted this study to document the details of LDLT for NASH in a Japanese LT center.
  
  
  METHODS
  Among all LDLT recipients in our institution from March 1996 to March 2013 (n = 425), we identified seven patients that underwent LDLT for NASH.
  
  
  RESULTS
  Of all the seven recipients, most of the patients (86%) were obese. The median follow-up period post-LDLT was 5.3 years. All were alive at the last follow-up. Recurrent NASH was detected in one patient (14%), and no recurrent hepatic steatosis was detected among the remaining six recipients on prospectively performed ultrasonography. No significant comorbidities were observed following donor surgery among the respective living donors during the follow-up period. We also retrospectively reviewed 22 patients with NASH-related end-stage liver disease (ESLD) who were evaluated but rejected for LDLT during the same period. The reasons for rejection for LDLT were presumably associated with the nature of NAFLD/NASH in either potential recipients or donors.
  
  
  CONCLUSIONS
  The post-transplant outcome of LDLT for NASH-related ESLD in our institution was feasible, although the sample size was small. Further studies in a larger patient cohort are warranted to investigate the long-term outcome of LDLT for NASH, both for recipients and living donors.
authors.affiliation: Organ Transplantation Service, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Sumihito
authors.initials: S
authors.lastname: Tamura
authors.forename: Junichi
authors.initials: J
authors.lastname: Kaneko
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takazawa
authors.forename: Taku
authors.initials: T
authors.lastname: Aoki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Noriyo
authors.initials: N
authors.lastname: Yamashiki
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
keywords: living donor liver transplantation; non-alcoholic fatty liver disease; non-alcoholic steatohepatitis