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Dig Liver Dis. 2018 Jan;50(1):68-75. doi: 10.1016/j.dld.2017.08.022. Epub 2017 Aug 12.

Liver transplantation for NASH cirrhosis is not performed at the expense of major post-operative morbidity.

Author information

1
Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: e.h.van.den.berg@umcg.nl.
2
Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
3
Department of Hepatopancreatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Abstract

BACKGROUND:

Non-alcoholic steatohepatitis (NASH) is an emerging indication for liver transplantation (LT) and coexists with multiple comorbidities. Obese and cirrhotic patients experience more perioperative complications. Limited data exist about short-term complications after LT for NASH cirrhosis.

AIM:

Investigate short-term complications in patients transplanted for NASH cirrhosis.

METHODS:

Single center retrospective cohort study including patients >18years who underwent LT between 2009-2015. Exclusion criteria were LT for acute liver failure and non-cirrhotic disease. Post-operative complications and severity within 90-days were classified using the Clavien-Dindo classification of surgical complications and comprehensive complication index (CCI). P<0.05 was significant.

RESULTS:

Out of 169 eligible patients, 34 patients (20.1%) were transplanted for NASH cirrhosis. These patients were significantly older (59.2 vs. 54.8 years, P=0.01), more obese (61.8% vs. 8.1%, P<0.01), had more diabetes mellitus (73.5% vs. 20%, P<0.01), metabolic syndrome (83.3% vs. 37.8%, P<0.01) and cardiovascular disease (29.4% vs. 11.1%, P<0.01). More grade 1 complications (OR 1.64, 95%CI 1.03-2.63, P=0.04) and more grade 2 urogenital infections (OR 3.4, 95%CI 1.1-10.6, P=0.03) were found. Major complications, CCI, 90-day mortality and graft survival were similar.

CONCLUSION:

Despite significantly increased comorbidities in patients transplanted for NASH cirrhosis, major morbidity, mortality and graft survival after 90days were comparable to patients transplanted for other indications.

KEYWORDS:

Clavien–Dindo classification; Comprehensive complication index; Liver transplantation; NASH cirrhosis; Short-term morbidity; Short-term mortality

PMID:
28935188
DOI:
10.1016/j.dld.2017.08.022
[Indexed for MEDLINE]

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