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World J Hepatol. Dec 27, 2021; 13(12): 1991-2004
Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.1991
De novo and recurrence of metabolic dysfunction-associated fatty liver disease after liver transplantation
Ma Ai Thanda Han, Raquel Olivo, Catherine J Choi, Nikolaos Pyrsopoulos
Ma Ai Thanda Han, Nikolaos Pyrsopoulos, Department of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ 07103, United States
Raquel Olivo, Department of Gastroenterology and Hepatology, Rutgers University, New Jersey Medical School, Newark, NJ 07103, United States
Catherine J Choi, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07101, United States
Author contributions: Han MAT, Olivo R and Choi CJ drafted of manuscript; Han MAT and Pyrsopoulos N critical revised of the manuscript for the important intellectual contents; Pyrsopoulos N contributed to administrative support and supervision.
Conflict-of-interest statement: Authors have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikolaos Pyrsopoulos, FAASLD, AGAF, FACG, MD, PhD, Director, Professor, Department of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, 185 South Orange Avenue, H-536, Newark, NJ 07103, United States.pyrsopni@njms.rutgers.edu
Received: March 28, 2021
Peer-review started: March 28, 2021
First decision: June 15, 2021
Revised: July 27, 2021
Accepted: November 25, 2021
Article in press: November 25, 2021
Published online: December 27, 2021
Abstract

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new acronym adopted from the consensus of international experts. Given the increasing prevalence of MAFLD in pre-transplant settings, de novo and recurrent graft steatosis/MAFLD are common in post-transplant settings. The impact of graft steatosis on long-term outcomes is unclear. The current knowledge of incidence rate, risk factors, diagnosis, long-term outcomes, and management of graft steatosis (both de novo and recurrent) is discussed in this review.

Keywords: Metabolic dysfunction-associated fatty liver disease, Metabolic dysfunction-associated steatohepatitis, De novo, Recurrent, Graft steatosis, Fibrosis, Survival

Core Tip: Metabolic dysfunction-associated fatty liver disease (MAFLD) is common after liver transplantation. Post transplant metabolic dysfunction, obesity and consequences of immunosuppressant contribute to the development of either de novo or recurrent graft steatosis. Post liver transplant MAFLD impact on cardiovascular outcome without significant impact on graft and patient survival. Weight control and tailoring of immunosuppression are the main strategies to prevent post liver transplant MAFLD.