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Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis.

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  • معلومة اضافية
    • Contributors:
      Université de Lille; Inserm; CHU Lille; Service d'Hépatologie Hôpital de la Croix-Rousse - HCL; Université Claude Bernard Lyon 1 UCBL; Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286; Service des Maladies de l'Appareil Digestif et de la Nutrition CHRU Lille; CHU Estaing Clermont-Ferrand; CHU Trousseau Tours; Hôpital de Hautepierre Strasbourg; Hôpital Edouard Herriot CHU - HCL; Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou; Centre Hépato-Biliaire Hôpital Paul Brousse CHB; CHU Pitié-Salpêtrière AP-HP; CHU Saint-Antoine AP-HP; Hôpital Henri Mondor; Hôpital Saint Eloi CHRU Montpellier; Hôpital Beaujon AP-HP; Hôpitaux universitaires de Genève = University Hospitals of Geneva HUG; Centre Hospitalier Universitaire de Nice CHU Nice; Hôpital de la Timone CHU - APHM TIMONE; Centre Hospitalier Universitaire CHU Grenoble CHUGA; Hôpital Haut-Lévêque CHU Bordeaux; Service des maladies du foie CHU Rennes; Centre Hospitalier Universitaire de Toulouse CHU Toulouse; Centre Hospitalier Régional Universitaire CHU Lille CHRU Lille; Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand CHU Dijon; Hôpital JeanMinjoz
    • الموضوع:
      2024
    • Collection:
      LillOA (Lille Open Archive - Université de Lille)
    • نبذة مختصرة :
      Background & aims: Liver transplantation (LT) is the only available treatment for end-stage non-alcoholic fatty liver disease (NAFLD) (related decompensated cirrhosis and/or hepatocellular carcinoma). The aim of our study was to evaluate the risk of disease recurrence after LT and the factors influencing it.Method: This retrospective multicenter study included adults transplanted for NAFLD cirrhosis between 2000 and 2019 in 20 participating French-speaking centers. Disease recurrence (steatosis, steatohepatitis and fibrosis) was diagnosed from liver graft biopsies.Results: We analyzed 150 patients with at least one graft liver biopsy available ≥6 months after transplantation, among 361 patients transplanted for NAFLD. The median (IQR) age at LT was 61.3 (54.4-64.6) years. The median follow-up after LT was 4.7 (2.8-8.1) years. The cumulative recurrence rates of steatosis and steatohepatitis at 5 years were 80.0% and 60.3%, respectively. Significant risk factors for steatohepatitis recurrence in multivariate analysis were recipient age at LT <65 years (odds ratio [OR] 4.214; p = 0.044), high-density lipoprotein-cholesterol <1.15 mmol/L after LT (OR 3.463; p = 0.013) and grade ≥2 steatosis on the graft at 1 year after LT (OR 10.196; p = 0.001). The cumulative incidence of advanced fibrosis (F3-F4) was 20.0% at 5 years after LT and significant risk factors from multivariate analysis were metabolic syndrome before LT (OR 8.550; p = 0.038), long-term use of cyclosporine (OR 11.388; p = 0.031) and grade ≥2 steatosis at 1 year after LT (OR 10.720; p = 0.049). No re-LT was performed for NAFLD cirrhosis recurrence.Conclusion: Our results strongly suggest that recurrence of initial disease after LT for NAFLD is inevitable and progressive in a large proportion of patients; the means to prevent it remain to be further evaluated.Impact and implications: Non-alcoholic fatty liver disease (NAFLD) is a growing indication for liver transplantation, but the analysis of disease recurrence, based on graft liver biopsies, ...
    • File Description:
      application/rdf+xml; charset=utf-8; application/pdf
    • Relation:
      JHEP Reports Innovation in Hepatology; JHEP Rep; http://hdl.handle.net/20.500.12210/100624
    • Rights:
      Attribution-NonCommercial-NoDerivs 3.0 United States ; info:eu-repo/semantics/openAccess
    • الرقم المعرف:
      edsbas.9582F04E