Title :

Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis.

Author(s) :

Villeret, François [Auteur]
Service d'Hépatologie [Hôpital de la Croix-Rousse - HCL]
Université Claude Bernard Lyon 1 [UCBL]
Dharancy, Sebastien [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille]
Erard, Domitille [Auteur]
Service d'Hépatologie [Hôpital de la Croix-Rousse - HCL]
Abergel, Armand [Auteur]
CHU Estaing [Clermont-Ferrand]
Barbier, Louise [Auteur]
CHU Trousseau [Tours]
Besch, Camille [Auteur]
Hôpital de Hautepierre [Strasbourg]
Boillot, Olivier [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Boudjema, Karim [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Coilly, Audrey [Auteur]
Centre Hépato-Biliaire [Hôpital Paul Brousse] [CHB]
Conti, Filomena [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Corpechot, Christophe [Auteur]
CHU Saint-Antoine [AP-HP]
Duvoux, Christophe [Auteur]
Hôpital Henri Mondor
Faitot, François [Auteur]
Hôpital de Hautepierre [Strasbourg]
Faure, Stéphanie [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Francoz, Claire [Auteur]
Hôpital Beaujon [AP-HP]
Giostra, Emiliano [Auteur]
Hôpitaux universitaires de Genève = University Hospitals of Geneva [HUG]
Gugenheim, Jean [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Hardwigsen, Jean [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Hilleret, Marie-Noelle [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Hiriart, Jean-Baptiste [Auteur]
Hôpital Haut-Lévêque [CHU Bordeaux]
Houssel-Debry, Pauline [Auteur]
Service des maladies du foie [CHU Rennes]
Kamar, Nassim [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Lassailly, Guillaume [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Latournerie, Marianne [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Pageaux, Georges-Philippe [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Samuel, Didier [Auteur]
Centre Hépato-Biliaire [Hôpital Paul Brousse] [CHB]
Vanlemmens, Claire [Auteur]
Hôpital JeanMinjoz
Saliba, Faouzi [Auteur]
Centre Hépato-Biliaire [Hôpital Paul Brousse] [CHB]
Dumortier, Jerome [Auteur]
Université Claude Bernard Lyon 1 [UCBL]

Journal title :

JHEP Reports Innovation in Hepatology

Abbreviated title :

JHEP Rep

Volume number :

5

Pages :

100668

Publication date :

2023-03-01

ISSN :

2589-5559

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background & aims: Liver transplantation (LT) is the only available treatment for end-stage non-alcoholic fatty liver disease (NAFLD) (related decompensated cirrhosis and/or hepatocellular carcinoma). The aim of our study ...
Show more >Background & aims: Liver transplantation (LT) is the only available treatment for end-stage non-alcoholic fatty liver disease (NAFLD) (related decompensated cirrhosis and/or hepatocellular carcinoma). The aim of our study was to evaluate the risk of disease recurrence after LT and the factors influencing it.Method: This retrospective multicenter study included adults transplanted for NAFLD cirrhosis between 2000 and 2019 in 20 participating French-speaking centers. Disease recurrence (steatosis, steatohepatitis and fibrosis) was diagnosed from liver graft biopsies.Results: We analyzed 150 patients with at least one graft liver biopsy available ≥6 months after transplantation, among 361 patients transplanted for NAFLD. The median (IQR) age at LT was 61.3 (54.4-64.6) years. The median follow-up after LT was 4.7 (2.8-8.1) years. The cumulative recurrence rates of steatosis and steatohepatitis at 5 years were 80.0% and 60.3%, respectively. Significant risk factors for steatohepatitis recurrence in multivariate analysis were recipient age at LT <65 years (odds ratio [OR] 4.214; p = 0.044), high-density lipoprotein-cholesterol <1.15 mmol/L after LT (OR 3.463; p = 0.013) and grade ≥2 steatosis on the graft at 1 year after LT (OR 10.196; p = 0.001). The cumulative incidence of advanced fibrosis (F3-F4) was 20.0% at 5 years after LT and significant risk factors from multivariate analysis were metabolic syndrome before LT (OR 8.550; p = 0.038), long-term use of cyclosporine (OR 11.388; p = 0.031) and grade ≥2 steatosis at 1 year after LT (OR 10.720; p = 0.049). No re-LT was performed for NAFLD cirrhosis recurrence.Conclusion: Our results strongly suggest that recurrence of initial disease after LT for NAFLD is inevitable and progressive in a large proportion of patients; the means to prevent it remain to be further evaluated.Impact and implications: Non-alcoholic fatty liver disease (NAFLD) is a growing indication for liver transplantation, but the analysis of disease recurrence, based on graft liver biopsies, has been poorly studied. Cumulative incidences of steatosis, steatohepatitis and NAFLD-related significant fibrosis recurrence at 5 years were 85.0%, 60.3% and 48.0%, respectively. Grade ≥2 steatosis on graft biopsy at 1 year (present in 25% of patients) is highly predictive of recurrence of steatohepatitis and advanced fibrosis: bariatric surgery should be discussed in these patients specifically.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T23:15:27Z
2024-03-08T10:27:18Z