RECURRENCE OF NONALCOHOLIC STEATOHEPATITIS FOLLOWING LIVER-TRANSPLANTATION

Patients with nonalcoholic steatohepatitis (NASH) may develop progress ive Liver dysfunction necessitating liver transplantation (OLT), We re port the incidence of recurrent disease and outcome in patients underg oing OLT for NASH, Patients transplanted for NASH were identified acco rding to pretransplant and explant liver histology. Patients with sign ificant alcohol consumption were excluded, Medical records were review ed to extract pre- and posttransplant data, including sequential body weight, biochemistry, and graft histology, Of 622 liver explants, eigh t patients had features consistent with NASH, All patients were female with a median age of 58, Seven patients were diagnosed with NASH preo peratively, including three who had undergone jejunoileal bypass, One patient was diagnosed as cryptogenic cirrhosis. At a median of 15 mont hs following OLT, all of the eight patients were alive with no graft f ailure, Six patients developed persistent fatty infiltration in their graft, three of whom had accompanying hepatocellular degeneration, con sistent with a diagnosis of recurrent NASH. In two patients, transitio n from mild steatosis to steatohepatitis and early fibrosis was observ ed over one to two years, The patients who did not develop recurrent s teatosis had significant weight loss following transplantation, althou gh the length of follow-up was relatively short, Patients undergoing O LT for NASH may develop recurrent steatosis shortly after transplantat ion, with possible progression to steatohepatitis and fibrosis, Althou gh longer follow-up is necessary to determine the eventual prognosis r elated to the recurrent fat and fibrosis in the graft, patients with e ndstage liver disease due to NASH should be considered good candidates for OLT.