title: The post-transplant course of patients undergoing liver transplantation for nonalcoholic steatohepatitis versus cryptogenic cirrhosis: a retrospective case-control study.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) can be considered the hepatic manifestation of the metabolic syndrome with nonalcoholic steatohepatitis (NASH) as its progressive form. With increasing prevalence of the metabolic syndrome, NASH cirrhosis is becoming a leading cause for liver transplantation. Some cases of orthotopic liver transplantation (OLT) due to cryptogenic cirrhosis (CC) might show typical features of NASH cirrhosis. Therefore, our aim was to assess recurrence of liver fibrosis in patients transplanted for NASH versus CC after OLT.
  
  
  METHODS
  Patients transplanted for CC or NASH between 1 January 2004 and 30 September 2015 were included. The histological NAFLD activity score and the NAFLD fibrosis score (NFS) were assessed.
  
  
  RESULTS
  In total, 15 and 12 patients underwent OLT because of NASH and CC, respectively. The case load for OLT because of NASH was constantly increasing (n=2 in 2004-2007 vs. n=9 in 2012-2015) whereas decreasing for CC (n=6 in 2004-2007 vs. n=2 in 2012-2015). Patient characteristics at OLT were similar, except for an older age and a higher BMI in NASH patients (59.1±2.2 vs. 51.8±2.9 years, P=0.05; 27.7±1.2 vs. 24.3±0.8 kg/m, P=0.035). Although post-OLT plasma lipid levels and incidence of de-novo hypertension, diabetes, and hyperlipidemia were similar between groups, the post-transplant NFS re-increased in the NASH group (but not in the CC: -0.1317 vs. -1.3645 at 12 months post-OLT, P=0.0400). Post-transplant survival was similar in NASH and CC patients.
  
  
  CONCLUSIONS
  According to the NFS, some NASH patients show recurrence of fibrosis as early as 6-12 months after OLT.
authors.affiliation: aDepartment of Surgery, Division of Transplantation bClinical Institute of Pathology cDepartment of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
authors.forename: Lukas W
authors.initials: LW
authors.lastname: Unger
authors.forename: Merima
authors.initials: M
authors.lastname: Herac
authors.forename: Katharina
authors.initials: K
authors.lastname: Staufer
authors.forename: Andreas
authors.initials: A
authors.lastname: Salat
authors.forename: Gerd
authors.initials: G
authors.lastname: Silberhumer
authors.forename: Michael
authors.initials: M
authors.lastname: Hofmann
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
authors.forename: Susanne
authors.initials: S
authors.lastname: Rasoul-Rockenschaub
authors.forename: Thomas
authors.initials: T
authors.lastname: Soliman
authors.forename: Thomas
authors.initials: T
authors.lastname: Reiberger
authors.forename: Gabriela A
authors.initials: GA
authors.lastname: Berlakovich
mesh_terms: D001317:Austria; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome