Histologically proven non‐alcoholic fatty liver disease and clinically related factors in recipients after liver transplantation

Non‐alcoholic fatty liver disease ( NAFLD ) affects a substantial proportion of the world population, and its prevalence has been increasing. The study was aimed at evaluating the prevalence and peri‐transplant risk factors for post‐liver transplantation ( LT ) NAFLD . A retrospective review was performed for adult recipients who underwent late protocol biopsy (>1 yr after LT ) between August 2010 and December 2012. Hepatic steatosis was reviewed and graded by hepatopathologists, and the peri‐transplant factors were analyzed for relationships to histologically proven NAFLD . Total 166 biopsies had been performed in 156 recipients. NAFLD was present in 27.1% at a mean period of 35.4 months between LT and biopsy, moderate and severe steatosis (≥33%) consisted of 28.9%. In multivariate analysis, pre‐ LT alcoholic cirrhosis (odds ratio [ OR ] 8.031, p   =   0.003), obesity at biopsy ( OR 3.873, p   =   0.001), and preexisting donor graft steatosis ( OR 3.147, p   =   0.022) were significant risk factors for post‐ LT NAFLD . In conclusion, NAFLD represented a considerable portion of recipients, but this prevalence was not higher than those for general population. Three risk factors were significantly related to post‐ LT NAFLD , and recipients with those factors should be monitored for NAFLD . Furthermore, possible progression to non‐alcoholic steatohepatitis ( NASH ) or fibrosis and metabolic syndrome should be considered in future studies.