Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 09 / 26 / 2020

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NAFLD Epidemiology, Emerging Pharmacotherapy, Liver Transplantation Implications and the Trends in the United States

Chiranjeevi Gadiparthi1Moshe Spatz2, Simi Greenberg3, Umair Iqbal*,4, Sowjanya Kanna5, Sanjaya K Satapathy6, Arkady Broder 1 and  Aijaz Ahmed7

1  Division of Gastroenterology, Hepatology and Clinical Nutrition, Saint Peter’s University Hospital, New Brunswick, NJ, USA
2  Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
3  Nova Southeastern University College of Osteopathic Medicine, Davie, FL, USA
4  Geisinger Commonwealth School of Medicine, Danville, PA, USA
5  Division of Gastroenterology, Allegheny Health Network, Tarentum, PA, USA
6  Northwell Health, Division of Hepatology & Sandra Atlas Bass Center for Liver Diseases, Manhasset, NY, USA
7  Stanford University School of Medicine, Division of Gastroenterology and Hepatology, Stanford, CA, USA
*Correspondence to: Umair Iqbal, Geisinger Commonwealth School of Medicine, Danville, PA 17822, USA. Tel: +1-607-282-2759, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2020;8(2):215-221 DOI: 10.14218/JCTH.2020.00014
Received: March 1, 2020 Accepted: May 5, 2020 Published online: May 29, 2020

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. The spread of obesity worldwide in pandemic proportions has led to a rapid rise of NAFLD in developed and developing countries alike. There are no approved pharmacological agents to treat steatohepatitis or advanced fibrosis but obeticholic acid recently has shown some promise in phase III trial. Currently, NAFLD is the number one etiology for simultaneous liver and kidney transplantation in the USA, second most common indication for liver transplantation (LT) and projected to become number one very soon. LT for NAFLD poses unique challenges, as these patients are generally older, obese and more likely to have a number of metabolic risk factors. Bariatric surgery is an option and can be considered if a structured weight loss program does not achieve the sustained weight loss goal. Comprehensive cardiovascular risk assessment and aggressive management of comorbid conditions are crucial in the LT evaluation process to improve post-transplant survival. Recurrent nonalcoholic steatohepatitis after LT is not uncommon, and thus warrants primary and secondary prevention strategies through a multidisciplinary approach. Prevalence of NAFLD in a donor population is a unique and growing concern that limits the access to quality liver grafts.

Keywords

NAFLD, NAFL, NASH, Liver transplantation

Journal of Clinical and Translational Hepatology 2020 vol. 8, 215-221 [ Html  ] [ PDF Full-text ]

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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