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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2018; 24(14): 1491-1506
Published online Apr 14, 2018. doi: 10.3748/wjg.v24.i14.1491
Nonalcoholic fatty liver disease and liver transplantation - Where do we stand?
Ivana Mikolasevic, Tajana Filipec-Kanizaj, Maja Mijic, Ivan Jakopcic, Sandra Milic, Irena Hrstic, Nikola Sobocan, Davor Stimac, Patrizia Burra
Ivana Mikolasevic, Ivan Jakopcic, Sandra Milic, Davor Stimac, Department of Gastroenterology, UHC Rijeka, School of Medicine, University of Rijeka, Rijeka 51000, Croatia
Tajana Filipec-Kanizaj, Maja Mijic, Nikola Sobocan, Department of Gastroenterology, University Hospital Merkur, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Irena Hrstic, Department of Internal medicine, General Hospital Pula, Pula, School of Medicine, University of Rijeka and Zagreb, Pula 52100, Croatia
Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua 35128, Italy
Author contributions: Mikolasevic I researched the database, analyzed data, wrote the manuscript, and is the guarantor of this work; Filipec-Kanizaj T, Mijic M, Jakopcic I, Milic S, Hrstic I, Sobocan N, Stimac D and Burra P contributed to the discussion and reviewed/edited the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ivana Mikolasevic, MD, PhD, Assistant Professor, Department of Gastroenterology, UHC Rijeka, Rijeka, Croatia, School of Medicine, University of Rijeka, 51000, Rijeka, Croatia. ivana.mikolasevic@gmail.com
Telephone: +385-51-658122 Fax: +385-51-658122
Received: February 18, 2019
Peer-review started: February 19, 2019
First decision: March 14, 2018
Revised: March 19, 2018
Accepted: March 25, 2018
Article in press: March 25, 2018
Published online: April 14, 2018
Processing time: 50 Days and 9.7 Hours
Abstract

Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a challenging and multisystem disease that has a high socioeconomic impact. NAFLD/NASH is a main cause of macrovesicular steatosis and has multiple impacts on liver transplantation (LT), on patients on the waiting list for transplant, on post-transplant setting as well as on organ donors. Current data indicate new trends in the area of chronic liver disease. Due to the increased incidence of metabolic syndrome (MetS) and its components, NASH cirrhosis and hepatocellular carcinoma caused by NASH will soon become a major indication for LT. Furthermore, due to an increasing incidence of MetS and, consequently, NAFLD, there will be more steatotic donor livers and less high quality organs available for LT, in addition to a lack of available liver allografts. Patients who have NASH and are candidates for LT have multiple comorbidities and are unique LT candidates. Finally, we discuss long-term grafts and patient survival after LT, the recurrence of NASH and NASH appearing de novo after transplantation. In addition, we suggest topics and areas that require more research for improving the health care of this increasing patient population.

Keywords: Nonalcoholic steatohepatitis; Chronic liver disease; Liver transplantation; Nonalcoholic fatty liver disease; Outcome

Core tip: Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a challenging and multisystem disease that has a high socioeconomic impact. NAFLD/NASH is a primary cause of macrovesicular steatosis and has several impacts on liver transplantation (LT), which is transmitted to transplant recipients and organ donors. Current data indicate a new trend in the area of chronic liver disease. Due to the increased incidence of metabolic syndrome (MetS) and its components, NASH cirrhosis and hepatocellular carcinoma caused by NASH will soon become a major indication for LT.