Optimizing patients with non-alcoholic fatty liver disease pre-transplant

被引:1
作者
Benmassaoud, Amine [1 ]
Deschenes, Marc [1 ]
Chen, Tianyan [1 ]
Ghali, Peter [1 ,2 ]
Sebastiani, Giada [1 ,3 ]
机构
[1] McGill Univ, Ctr Hlth, Dept Medicine, Div Gastroenterol & Hepatol, 1001 Blvd Decarie, Montreal, PQ H4A 3J1, Canada
[2] Univ Florida, Div Gastroenterol, Dept Med, Jacksonville, FL USA
[3] McGill Univ, Ctr Hlth, Dept Med, Chron Viral Illness Serv, Montreal, PQ, Canada
来源
CANADIAN LIVER JOURNAL | 2020年 / 3卷 / 03期
关键词
cardiovascular risk; metabolic comorbidities; nonalcoholic fatty liver disease; obesity treatment; pre-transplant; referral; BODY-MASS INDEX; SLEEVE GASTRECTOMY; HEPATOCELLULAR-CARCINOMA; CARDIOVASCULAR-DISEASE; TRANSPLANT RECIPIENTS; AMERICAN ASSOCIATION; NATURAL-HISTORY; SURVIVAL; MORTALITY; OUTCOMES;
D O I
10.3138/canlivj-2019-0025
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries. Non-alcoholic steatohepatitis (NASH), which is the progressive counterpart of the disease, is becoming the leading indication for liver transplantation in North America. Owing to the lack of symptoms, NASH is often an incidental diagnosis, resulting in a significant proportion of patients being diagnosed when advanced liver disease has already developed. NAFLD has recently been characterized as the hepatic manifestation of metabolic syndrome. Consequently, it is a multisystem disease that often co-exists with several other conditions, such as obesity, diabetes, cardiovascular diseases, and extra-hepatic malignancy, which have an impact on selection of transplant recipients. The complexity of diagnostic approach, need for multidisciplinary clinical management, and lack of a specific treatment further complicate the picture of this extremely prevalent liver condition. NAFLD patients with advanced liver disease should be considered for early referral to liver transplant clinics for careful metabolic and cardiovascular risk stratification because they have worse survival rates after liver transplantation than other patients with chronic liver disease. Early referral will also facilitate optimization of metabolic comorbidities before proceeding with transplantation. This review provides an overview of strategies to identify patients with advanced NAFLD, with an emphasis on the management of associated comorbidities and optimal timing of pre-transplant evaluation. Other topics that have been shown to affect recipient optimization, such as the role of lifestyle changes and bariatric surgery in the management of obesity, as well as sarcopenia in decompensated NASH-related cirrhosis, are addressed.
引用
收藏
页码:237 / 250
页数:14
相关论文
共 62 条
[1]   Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases [J].
Adams, Leon A. ;
Anstee, Quentin M. ;
Tilg, Herbert ;
Targher, Giovanni .
GUT, 2017, 66 (06) :1138-1153
[2]   The diagnostic and prognostic utility of risk factors defined by the AHA/ACCF on the evaluation of cardiac disease in liver transplantation candidates [J].
Alexander, Sarah ;
Teshome, Meron ;
Patel, Hena ;
Chan, Edie Y. ;
Doukky, Rami .
BMC CARDIOVASCULAR DISORDERS, 2019, 19 (1)
[3]   Associations between nonalcoholic fatty liver disease and ischemic stroke [J].
Alkagiet, Stelina ;
Papagiannis, Achilleas ;
Tziomalos, Konstantinos .
WORLD JOURNAL OF HEPATOLOGY, 2018, 10 (07) :474-478
[4]   Neurological complications after orthotopic liver transplantation [J].
Amodio, P. ;
Biancardi, A. ;
Montagnese, S. ;
Angeli, P. ;
Iannizzi, P. ;
Cillo, U. ;
D'Amico, D. ;
Gatta, A. .
DIGESTIVE AND LIVER DISEASE, 2007, 39 (08) :740-747
[5]   Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis [J].
Anstee, Quentin M. ;
Targher, Giovanni ;
Day, Christopher P. .
NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY, 2013, 10 (06) :330-344
[6]   NAFLD as a Sexual Dimorphic Disease: Role of Gender and Reproductive Status in the Development and Progression of Nonalcoholic Fatty Liver Disease and Inherent Cardiovascular Risk [J].
Ballestri, Stefano ;
Nascimbeni, Fabio ;
Baldelli, Enrica ;
Marrazzo, Alessandra ;
Romagnoli, Dante ;
Lonardo, Amedeo .
ADVANCES IN THERAPY, 2017, 34 (06) :1291-1326
[7]   Blood Pressure Targets in Subjects With Type 2 Diabetes Mellitus/Impaired Fasting Glucose Observations From Traditional and Bayesian Random-Effects Meta-Analyses of Randomized Trials [J].
Bangalore, Sripal ;
Kumar, Sunil ;
Lobach, Iryna ;
Messerli, Franz H. .
CIRCULATION, 2011, 123 (24) :2799-+
[8]   Obesity as predictor of postoperative outcomes in liver transplant candidates: Review of the literature and future perspectives [J].
Barone, Michele ;
Viggiani, Maria Teresa ;
Avolio, Alfonso W. ;
Iannone, Andrea ;
Rendina, Maria ;
Di Leo, Alfredo .
DIGESTIVE AND LIVER DISEASE, 2017, 49 (09) :957-966
[9]   Screening for nonalcoholic steatohepatitis by using cytokeratin 18 and transient elastography in HIV mono-infection [J].
Benmassaoud, Amine ;
Ghali, Peter ;
Cox, Joseph ;
Wong, Philip ;
Szabo, Jason ;
Deschenes, Marc ;
Osikowicz, Maria ;
Lebouche, Bertrand ;
Klein, Marina B. ;
Sebastiani, Giada .
PLOS ONE, 2018, 13 (01)
[10]   Physical Activity and Liver Diseases [J].
Berzigotti, Annalisa ;
Saran, Uttara ;
Dufour, Jean-Francois .
HEPATOLOGY, 2016, 63 (03) :1026-1040