NAFLD and liver transplantation: Current burden and expected challenges.
NAFLD and liver transplantation: Current burden and expected challenges.
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DOI：
10.1016/j.jhep.2016.07.033
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发表时间：
2016-12
影响因子：
25.7
通讯作者：
Conti F
中科院分区：
文献类型：
--
作者：
Pais R;Barritt AS 4th;Calmus Y;Scatton O;Runge T;Lebray P;Poynard T;Ratziu V;Conti F
由于肥胖和2型糖尿病的全球流行，非酒精性脂肪性肝病(NAFLD)在欧洲和美国的患病率正在上升，成为慢性肝病最常见的原因之一，可以预见，它是终末期肝病和肝细胞癌患者进行肝移植的主要原因之一。对于世界各地的大多数移植团队来说，这将在移植前和移植后的管理方面提出许多挑战。在这里，我们回顾NAFLD对肝移植的多方面影响，并将讨论：(1)NAFLD是隐源性肝硬变、终末期慢性肝病和肝细胞癌的常见原因；(2)NAFLD在欧洲和美国作为肝移植适应症的患病率；(3)NAFLD对供体池的影响；(4)NAFLD患者接受肝移植的机会及其在代谢、肾脏和血管并发症方面的等待名单上的处理；(5)移植后代谢综合征、复发和新发NAFLD的患病率和后果；(6)改善长期结果的替代管理和治疗选择，特别强调纠正和控制代谢合并症。
Because of global epidemics of obesity and type 2 diabetes, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing both in Europe and the United States, becoming one of the most frequent causes of chronic liver disease and predictably, one of the leading causes of liver transplantation both for end-stage liver disease and hepatocellular carcinoma. For most transplant teams around the world this will raise many challenges in terms of preand post-transplant management. Here we review the multifaceted impact of NAFLD on liver transplantation and will discuss: (1) NAFLD as a frequent cause of cryptogenic cirrhosis, end-stage chronic liver disease, and hepatocellular carcinoma; (2) prevalence of NAFLD as an indication for liver transplantation both in Europe and the United States; (3) the impact of NAFLD on the donor pool; (4) the access of NAFLD patients to liver transplantation and their management on the waiting list in regard to metabolic, renal and vascular comorbidities; (5) the prevalence and consequences of post-transplant metabolic syndrome, recurrent and de novo NAFLD; (6) the alternative management and therapeutic options to improve the long-term outcomes with particular emphasis on the correction and control of metabolic comorbidities.