Zatta R, Silva LSD, Felga G, Pimentel CF. Are we standing on the shifting sands of post-transplant metabolic-associated steatotic liver disease? World J Hepatol 2025; 17(7): 107837 [DOI: 10.4254/wjh.v17.i7.107837]
Corresponding Author of This Article
Guilherme Felga, MD, PhD, Tenured Assistant Professor, Discipline of Gastroenterology, Department of Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo, Rua Pedro de Toledo, 861/869, São Paulo 04039-032, Brazil. guilherme.felga@unifesp.br
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
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/
World J Hepatol. Jul 27, 2025; 17(7): 107837 Published online Jul 27, 2025. doi: 10.4254/wjh.v17.i7.107837
Are we standing on the shifting sands of post-transplant metabolic-associated steatotic liver disease?
Renata Zatta, Luana S da Silva, Guilherme Felga, Carolina FMG Pimentel
Renata Zatta, Luana S da Silva, Guilherme Felga, Carolina FMG Pimentel, Liver Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
Renata Zatta, Luana S da Silva, Guilherme Felga, Carolina FMG Pimentel, Discipline of Gastroenterology, Department of Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo 04039-032, Brazil
Author contributions: Zatta R, da Silva LS, Pimentel CFMG, and Felga G designed the research study, performed the data collection, analysis, and interpretation, and contributed to the drafting of the manuscript; Pimentel CFMG and Felga G revised the manuscript for important intellectual content. All authors read and approved the final version of the manuscript.
Supported by The LTx Unit at Hospital Israelita Albert Einstein is financed by the Programa de Apoio ao Desenvolvimento Insitucional do SUS (PROADI-SUS), a partnership with the Brazilian Ministry of Health, No. 25000.171086/2023-80.
Conflict-of-interest statement: The authors have no relevant conflict of interests.
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: Guilherme Felga, MD, PhD, Tenured Assistant Professor, Discipline of Gastroenterology, Department of Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo, Rua Pedro de Toledo, 861/869, São Paulo 04039-032, Brazil. guilherme.felga@unifesp.br
Received: April 1, 2025 Revised: April 30, 2025 Accepted: July 7, 2025 Published online: July 27, 2025 Processing time: 118 Days and 15.5 Hours
Core Tip
Core Tip: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the fastest-growing indication for liver transplantation (LTx) in Western countries, and the recurrence rate approaches 100% at 5 years. Recurrent disease progresses faster than native liver MASLD and is driven by immunosuppression-mediated metabolic dysregulation. Immunosuppressive regimens may have limitations, and even though there is need for tailored strategies, evidence is lacking for their application in post-LTx MASLD. Histological assessment remains essential for risk stratification despite advances in noninvasive diagnostics. Optimized immunosuppression, metabolic control, and emerging therapies are key research priorities to improve outcomes. Standardized guidelines for post-LTx MASLD management are urgently needed.
