P- 7 RISK FACTORS FOR NON-ALCOHOLIC FATTY LIVER DISEASE AFTER LIVER TRANSPLANTATION

Introduction and Objectives

Non-alcoholic fatty liver disease (NAFLD) is considered the liver manifestation of metabolic syndrome (MS) and is a common complication after liver transplantation (LT). This study aimed to assess the frequency of NAFLD and new onset diabetes after LT (NODALT), as well as associated risk factors.

Materials and Methods

142 LT patients aged 18 years or older were included. We collected clinical, anthropometric, and laboratory data and performed hepatic ultrasound and elastography using 2D shear-wave technique.

Results

Of the participants, 62.7% were male (mean age 60±21 years). Alcoholic cirrhosis was the primary cause of LT in 27% of cases. The mean change in weight after LT was +8.9 kg. Liver steatosis was identified in 37 participants (26.1%). The proportion of obese or overweight individuals (73% vs. 56%), diabetes mellitus (65% vs. 38%), dyslipidemia (65% vs. 50%), and MS (65% vs. 39%) was higher in the group with hepatic steatosis compared to those without. In multivariate analysis, hypertriglyceridemia (OR=2.80, 95%CI 1.22-6.43, p=0.015) and NODALT (OR=2.65, 95%CI 1.15-6.10, p=0.022) were identified as risk factors for NAFLD. NODALT occurred in 44 individuals (31%) and was associated with time from LT (OR=1.009, 95%CI 1.003-1.015, p=0.004), current body mass index (OR=1.105, 95%CI 1.014-1.204, p=0.022), and fatty liver (OR=2.832, 95%CI 1.082-7.415, p=0.034). Prevalence of advanced chronic liver disease, according to elastography, was 11%. The concordance between non-invasive scores and 2D-SWE was very low, with only 38% for FIB4 and 31% for NFS when elastography indicated advanced fibrosis and 25% and 20% for FIB4 and NFS, respectively, when elastography indicated the absence of advanced fibrosis.

Conclusions

NAFLD, liver fibrosis and NODALT are common after LT. There is a need for improved non-invasive methods to accurately identify advanced fibrosis in LT patients.