Graft fibrosis and recipient survival in postorthotopic liver transplant nonalcoholic fatty liver disease

Hany R. Alwakeel, Hasan E. Zaghla, Nabeel A. Omar, Hasan A. Alashinnawy, Eman A. Rewisha, Paulo A. Fontes, Michael De Vera, Eizaburo Sasatomi, Azza A. Taha, Hossam M. Kandil

Research output: Contribution to journalArticlepeer-review


Background and purpose Both de-novo and recurrent nonalcoholic fatty liver disease (NAFLD) are increasingly being reported in postorthotopic liver transplant (post-OLT) patients. We evaluated graft fibrosis and recipient survival in post-OLT steatosis and steatohepatitis. Patients and Methods On the basis of post-OLT liver biopsy results, post-OLT patients were divided into control (without nonalcoholic fatty liver disease), post-OLT steatosis, or post-OLT nonalcoholic steatohepatitis (NASH). The extent of graft fibrosis and patient survival were compared among the three groups. Results A total of 123 OLT recipients were included with a 12-month median follow-up (2.07-52.83). They underwent 181 post-OLT liver biopsies, with 41.6% having two or more biopsies. Post-OLT steatosis and post-OLT NASH were observed in 10.6 and 18.7%, respectively. Independent risk factors were sex, pre-OLT NASH, and pre-OLT obesity for post-OLT steatosis and pre-OLT NASH and pre-OLT obesity for post-OLT NASH. The rate of moderate-to-severe fibrosis (3-4/4) was 0% in post-OLT steatosis, 13% in post-OLT NASH, and 17.2% in the control. Twenty patients died and age was the only independent predictor of mortality. All deaths in the post-OLT NASH (9%) occurred within 1 year of OLT and none was due to graft loss. No mortality was observed in the post-OLT steatosis group. Conclusion Pre-OLT NASH and obesity are independent risk factors for post-OLT NASH. Within the 12-week median follow-up of post-OLT patients, significant graft fibrosis was observed in 13% of the patients with post-OLT NASH but not in post-OLT steatosis. Our data suggest that prevention, in high-risk patients, and management of post-OLT NASH should start as early as possible after OLT.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalEgyptian Liver Journal
Issue number1
StatePublished - Jan 2012
Externally publishedYes


  • Graft fibrosis
  • Post-OLT NAFLD
  • Post-OLT NASH
  • Recipient survival

ASJC Scopus subject areas

  • Hepatology


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