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Impact of living donor liver transplantation on long-term cardiometabolic and graft outcomes in cirrhosis due to nonalcoholic steatohepatitis.

Publication ,  Journal Article
Karnam, RS; Azhie, A; Yang, C; Rogalsky, A; Chen, S; Xu, W; Patel, K; Selzner, N; Lilly, L; Cattral, M; Bhat, M
Published in: Clin Transplant
September 2023

BACKGROUND AND AIM: Non-alcoholic steatohepatitis (NASH) is a leading indication for liver transplantation (LT). This study aimed to determine whether living donor LT (LDLT) recipients experienced less recurrent NASH, cirrhosis, and cardiometabolic complications compared to deceased donor LT (DDLT). METHOD: Patients with LDLT and DDLT for NASH between February 2002 and May 2018 at University Health Network (UHN) were compared. Cox Proportional Hazard model was used to analyze overall survival (OS), Fine and Gray's Competing Risk models were conducted to analyze cumulative incidence of post LT outcomes. RESULTS: One hundred and ninety-nine DDLTs and 66 LDLTs were performed for NASH cirrhosis. Time and rate of recurrence of NAFLD and NASH were comparable in both groups. Graft cirrhosis was more common in DDLT recipients (n = 14) versus LDLT (n = 0) (p < .0001). Significant fibrosis (Fibrosis ≥ F2) developed in 50 recipients (12 LDLT and 38 DDLT) post LT (DDLT vs. LDLT: HR = 1.00, 95% CI = (.52-1.93), p = .91) and there was no difference in time to significant fibrosis (p = .57). There was no difference in development of post-transplant diabetes, dyslipidemia, metabolic syndrome, cardiovascular disease, and cancers. LDLT group had better renal function at 10 years (MDRD eGFR of 57.0 mL/min vs. 48.5 mL/min, p = .047). Both groups had a comparable OS (HR = 1.83 (95% CI = .92-3.62), p = .08). CONCLUSION: Overall, LDLT recipients had significantly better renal function by virtue of having early transplantation in their disease course. LDLT was also associated with significantly less graft cirrhosis, although OS and cardiometabolic outcomes were comparable between LDLT and DDLT.

Duke Scholars

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

September 2023

Volume

37

Issue

9

Start / End Page

e15008

Location

Denmark

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Non-alcoholic Fatty Liver Disease
  • Living Donors
  • Liver Transplantation
  • Humans
  • Graft Survival
  • Fibrosis
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Karnam, R. S., Azhie, A., Yang, C., Rogalsky, A., Chen, S., Xu, W., … Bhat, M. (2023). Impact of living donor liver transplantation on long-term cardiometabolic and graft outcomes in cirrhosis due to nonalcoholic steatohepatitis. Clin Transplant, 37(9), e15008. https://doi.org/10.1111/ctr.15008
Karnam, Ravikiran S., Amirhossein Azhie, Cathy Yang, Andrew Rogalsky, Shiyi Chen, Wei Xu, Keyur Patel, et al. “Impact of living donor liver transplantation on long-term cardiometabolic and graft outcomes in cirrhosis due to nonalcoholic steatohepatitis.Clin Transplant 37, no. 9 (September 2023): e15008. https://doi.org/10.1111/ctr.15008.
Karnam RS, Azhie A, Yang C, Rogalsky A, Chen S, Xu W, et al. Impact of living donor liver transplantation on long-term cardiometabolic and graft outcomes in cirrhosis due to nonalcoholic steatohepatitis. Clin Transplant. 2023 Sep;37(9):e15008.
Karnam, Ravikiran S., et al. “Impact of living donor liver transplantation on long-term cardiometabolic and graft outcomes in cirrhosis due to nonalcoholic steatohepatitis.Clin Transplant, vol. 37, no. 9, Sept. 2023, p. e15008. Pubmed, doi:10.1111/ctr.15008.
Karnam RS, Azhie A, Yang C, Rogalsky A, Chen S, Xu W, Patel K, Selzner N, Lilly L, Cattral M, Bhat M. Impact of living donor liver transplantation on long-term cardiometabolic and graft outcomes in cirrhosis due to nonalcoholic steatohepatitis. Clin Transplant. 2023 Sep;37(9):e15008.
Journal cover image

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

September 2023

Volume

37

Issue

9

Start / End Page

e15008

Location

Denmark

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Non-alcoholic Fatty Liver Disease
  • Living Donors
  • Liver Transplantation
  • Humans
  • Graft Survival
  • Fibrosis
  • 1103 Clinical Sciences