Prevalence of fatty liver disease after liver transplantation and risk factors for recipients and donors

Ann Hepatol. 2022 Mar-Apr;27(2):100670. doi: 10.1016/j.aohep.2022.100670. Epub 2022 Jan 17.


Introduction and objectives: Fatty liver disease (FLD) may develop in liver transplant recipients. We investigated the recipient and donor risk factors for FLD development after liver transplantation (LT).

Methods: A total of 108 liver transplant recipients (54 men [50.0%]; median age, 52 [20-68] years) treated from 2011-2020 was enrolled. Three recipients died at < 3 months as a result of infection or blood flow impairment, and were excluded from the long-term FLD study. On evaluation of 88 prospective living donors, fatty liver was observed in 21. The prevalence and risk factors for FLD and survival were evaluated.

Results: After LT, 28 of 105 recipients (26.7%) developed FLD. FLD was more common in patients with a high body mass index (BMI) and dyslipidemia (both p < 0.01), primary nonalcoholic steatohepatitis (p = 0.02), after living-donor LT (p = 0.03) and everolimus (EVL) use (p = 0.08). Factors predictive of FLD included EVL use and a high BMI (hazard ratios = 3.00 and 1.34; p = 0.05 and p < 0.01, respectively). Sixteen donors lost 6.5 kg (range: 2.0-16.0 kg) of body weight prior to LT. However, there were no cases of primary non-function, which did not affect the FLD prevalence. Development of FLD did not have a negative impact on LT outcome; the 5-year survival rate was 92.6%.

Conclusions: Recipient factors were more important than donor factors for FLD onset after LT.

Keywords: Everolimus (EVL); Fatty liver disease (FLD); Liver transplantation (LT).

MeSH terms

  • Female
  • Humans
  • Liver Transplantation* / adverse effects
  • Living Donors
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease* / diagnosis
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Non-alcoholic Fatty Liver Disease* / etiology
  • Prevalence
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Tissue Donors
  • Treatment Outcome