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Recurrent nonalcoholic steatohepatitis and cirrhosis after liver transplantation
Author(s) -
Molloy R M,
Komorowski R,
Varma R R
Publication year - 1997
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500030212
Subject(s) - nonalcoholic steatohepatitis , cirrhosis , liver transplantation , medicine , steatohepatitis , gastroenterology , transplantation , steatosis , nonalcoholic fatty liver disease , fatty liver , disease
Abstract Nonalcoholic steatohepatitis (NASH) may progress to cirrhosis and lead to liver failure. Histologically, NASH is often indistinguishable from liver disease caused by alcohol use; the cause of NASH remains unknown. A subgroup of patients with NASH eventually develops fibrosis and/or cirrhosis, and in many cases, transplantation is performed for end‐ stage liver disease attributed to steatohepatitis in patients who do not consume alcohol. The patient described received a transplant for end‐stage liver disease secondary to NASH with cirrhosis. Postoperatively she did well, with a bout of mild rejection treated successfully at week 9 with prompt normalization of liver tests. Weight and glycemic control were optimized, and steroid therapy was minimized as safely as possible. Repeat liver biopsy at week 66, however, for persistent mild elevation of alkaline phosphatase and γ‐glutamyl‐ transferase surprisingly revealed the “recurrence” of NASH. Subsequent biopsy revealed NASH with cirrhosis by week 76 after transplantation. Subsequent biopsy at week 87 has confirmed cirrhosis. The patient does not consume alcohol. It is believed to be the first reporting of such a case.