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World J Gastroenterol. Dec 28, 2013; 19(48): 9146-9155
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9146
Non-alcoholic fatty liver disease and liver transplantation: Outcomes and advances
Adnan Said
Adnan Said, Division of Gastroenterology and Hepatology, Department of Medicine, Transplant Hepatology, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53705, United States
Author contributions: Said A contributed to the manuscript.
Correspondence to: Adnan Said, MD, MS, Division of Gastroenterology and Hepatology, Department of Medicine, Transplant Hepatology, School of Medicine and Public Health, University of Wisconsin, Wm. S. Middleton VAMC, 4223 MFCB, 1685 Highland Avenue, Madison, WI 53705, United States. axs@medicine.wisc.edu
Telephone: +1-608-2634034 Fax: +1-608-2655677
Received: October 1, 2013
Revised: October 28, 2013
Accepted: November 1, 2013
Published online: December 28, 2013
Processing time: 105 Days and 6.7 Hours
Core Tip

Core tip: Non-alcoholic fatty liver disease (NAFLD) is a prevalent indication for liver transplantation. It also poses a risk to organ donation, with decreasing rates of suitable allografts. NAFLD frequently recurs in the allograft or develops de novo. Post-transplant recurrence is related to obesity and immunosuppression associated metabolic derangements. A polymorphism in PNPLA3 also increases recurrence risk. Pre-transplant data favors sustained weight loss through diet and exercise as the most effective therapy for NAFLD. Vitamin E and insulin-sensitizing agents are occasionally used. Trials on immune-suppression regimens in this population are sorely needed. A multimodality approach to treatment should be utilized in management of post-transplant NAFLD.