Premium
Recurrent familial hypobetalipoproteinemia–induced nonalcoholic fatty liver disease after living donor liver transplantation
Author(s) -
Harada Noboru,
Soejima Yuji,
Taketomi Akinobu,
Yoshizumi Tomoharu,
Uchiyama Hideaki,
Ikegami Toru,
Saibara Toshiharu,
Nishizaki Takashi,
Maehara Yoshihiko
Publication year - 2009
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21766
Subject(s) - medicine , liver transplantation , nonalcoholic fatty liver disease , living donor liver transplantation , gastroenterology , fatty liver , transplantation , disease
Familial hypobetalipoproteinemia (FHBL) is one of the causes of nonalcoholic steatohepatitis (NASH) and a codominant disorder. Patients heterozygous for FHBL may be asymptomatic, although they demonstrate low plasma levels of low‐density lipoprotein (LDL) cholesterol and apolipoprotein B. Here we report a nonobese 54‐year‐old man with decompensated liver cirrhosis who underwent living donor liver transplantation with his son as the donor. Low albuminemia and refractory ascites persisted after transplantation. A biopsy specimen obtained 11 months after liver transplantation revealed severe steatosis and fibrosis, and recurrent NASH was diagnosed on the basis of pathological findings. Both the patient's and donor's laboratory tests demonstrated low LDL cholesterol and apolipoprotein levels. Because mutations in messenger RNAs of microsomal triglyceride transfer protein and apolipoprotein B genes were excluded neither in the recipient nor in the donor, both were clinically diagnosed as being heterozygous for FHBL. We successfully treated the recipient with heterozygous FHBL–induced recurrent NASH after liver transplantation using our diet and exercise programs. Liver Transpl 15:806–809, 2009. © 2009 AASLD.