De Novo Nonalcoholic Fatty Liver Disease After Liver... : Liver Transplantation (original) (raw)

Original Articles: De Novo Nonalcoholic Fatty Liver Disease

Seo, Suk1,*,†; Maganti, Kalyani1; Khehra, Manjit1; Ramsamooj, Rajendra2; Tsodikov, Alexander3; Bowlus, Christopher1; McVicar, John4; Zern, Mark1; Torok, Natalie1

1_Division of Gastroenterology and Hepatology, University of California Davis Medical Center, Sacramento, CA_

2_Division of Pathology, University of California Davis Medical Center, Sacramento, CA_

3_Division of Biostatistics, University of California Davis Medical Center, Sacramento, CA_

4_Department of Surgery, University of California Davis Medical Center, Sacramento, CA_

*Address reprint requests to Division of Gastroenterology/Hepatology, UC Davis Medical Center, 4150 V Street, Suite 3500, Sacramento, CA 95817

Email: [email protected]

Received 27 April 2006; accepted 23 July 2006

Published online in Wiley InterScience (www.interscience.wiley.com).

†Telephone: 916-734-3751; FAX: 916-734-7908

Abstract

Hepatic steatosis is a recognized problem in patients after orthotopic liver transplant (OLT). However, de novo development of nonalcoholic fatty liver disease (NAFLD) has not been well described. The aim of this study was to determine the prevalence and predictors of de novo NAFLD after OLT. A retrospective analysis was performed on 68 OLT patients with donor liver biopsies and posttransplantation liver biopsies. Individual medical charts were reviewed for demographics, indication for OLT, serial histology reports, genotypes for hepatitis C, comorbid conditions, and medications. Liver biopsies were reviewed blindly and graded according to the Brunt Scoring System. Multivariate logistic regression analysis was used to study the risk factors for developing NAFLD. The interval time from OLT to subsequent follow-up liver biopsy was 28 ± 18 months. A total of 12 patients (18%) developed de novo NAFLD, and 6 (9%) developed de novo NASH. The regression model indicated that the use of angiotensin-converting enzyme inhibitors (ACE-I) was associated with a reduced risk of developing NAFLD after OLT (odds ratio, 0.09; 95% confidence interval, 0.010-0.92; P = 0.042). Increase in body mass index (BMI) of greater than 10% after OLT was associated with a higher risk of developing NAFLD (odds ratio, 19.38; 95% confidence interval, 3.50-107.40; P = 0.001). In conclusion, de novo NAFLD is common in the post-OLT setting, with a significant association with weight gain after transplant. The use of an ACE-I may reduce the risk of developing post-OLT NAFLD. Liver Transpl, 2006. © 2006 AASLD.