Steatosis Following Liver Transplantation for Nonalcoholic Steatohepatitis is Associated with a Higher Rate of Cardiovascular Complications

W. Alhamoudi¹, S. Alqahtani², K. Bzeizi², A. Albenmousa², Y. Saleh², D. Broering², S. Alghamdi²

¹Medicine, King Saud University, Riyadh, Saudi Arabia, ²Liver Transplantation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

Meeting: 2022 American Transplant Congress

Abstract number: 852

Keywords: Liver transplantation, Metabolic complications, Renal dysfunction, Survival

Topic: Clinical Science » Liver » 51 - Liver: Retransplantation and Other Complications

Session Information

Session Name: Liver: Retransplantation and Other Complications

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: Cirrhosis secondary to Nonalcoholic Steatohepatitis (NASH) is projected to become the leading indication for liver transplantation (LT) worldwide. Objectives: to evaluate the prevalence of metabolic syndrome and long term outcome of patients transplanted for NASH related cirrhosis.

*Methods: All patients transplanted for NASH related cirrhosis at our institution from 2001-2016 were included in this study. Patients data were collected from our prospectively collected database.

*Results: 108 patients were transplanted for NASH related cirrhosis at our institution. Sixteen (15%) patients had pretransplant hepatocellular carcinoma. Pretransplant obesity (BMI>30), diabetes, hyperlipidemia and hypertension were present in 37(34%), 55(51%), 20(19%), and 30(28%) patients, respectively. Following LT patients were followed for an average of 103 months (range 54-203 months). Post-transplant diabetes, hyperlipidemia and hypertension were present in 73(67.6%), 25(23%) and 51 (47%) patients, respectively. 58 (53.7%) patients developed disease recurrence with significant fatty infiltration on various imaging modalities. Additionally, 48(44%) patients developed renal impairment (GFR<60). Sixteen patients were treated for mild rejection and only one patient developed ductopenic rejection resulting in graft loss. Eighteen (16.6%) patients developed severe cardiovascular complications. Overall survival during the follow period was 83%. One and three year survivals were 92.5% and 87% respectively. Sepsis was the commonest cause of death in our patient population. Three patients died secondary to acute cardiovascular events. In Univariate and multivariate analysis recurrence of steatosis was associated with cardiovascular complications.

*Conclusions: Disease recurrence in our patient population was common and was associated with a higher rate of cardiovascular complications; however, post-transplant cirrhosis remains rare. The prevalent metabolic syndrome negatively impacted renal function and resulted in cardiovascular complications.

To cite this abstract in AMA style:

Alhamoudi W, Alqahtani S, Bzeizi K, Albenmousa A, Saleh Y, Broering D, Alghamdi S. Steatosis Following Liver Transplantation for Nonalcoholic Steatohepatitis is Associated with a Higher Rate of Cardiovascular Complications [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/steatosis-following-liver-transplantation-for-nonalcoholic-steatohepatitis-is-associated-with-a-higher-rate-of-cardiovascular-complications/. Accessed May 30, 2025.

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