Overweight Impacts Histological Disease Activity of De Novo Metabolic Dysfunction‐Associated Steatotic Liver Disease After Liver Transplantation

ABSTRACT Background and Aims Metabolic dysfunction‐associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is...

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Vydáno v:	Clinical transplantation Ročník 38; číslo 11; s. e70039 - n/a
Hlavní autoři:	Campos‐Murguia, Alejandro, Guetzlaff, Lea, Bosselmann, Emily, Engel, Bastian, Hartleben, Björn, Wedemeyer, Heiner, Jaeckel, Elmar, Taubert, Richard, Hupa‐Breier, Katharina Luise
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Denmark John Wiley and Sons Inc 01.11.2024
Témata:	Adult Fatty Liver - etiology Fatty Liver - metabolism Fatty Liver - pathology Female fibrosis Follow-Up Studies Graft Survival Humans Liver Transplantation - adverse effects Male Metabolic Diseases - etiology Metabolic Diseases - pathology metabolic dysfunction‐associated steatohepatitis metabolic syndrome Middle Aged Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - etiology Non-alcoholic Fatty Liver Disease - metabolism Non-alcoholic Fatty Liver Disease - pathology nonalcoholic fatty liver disease Original Overweight - complications Postoperative Complications Prognosis protocol biopsy Retrospective Studies Risk Factors metabolic syndrome nonalcoholic fatty liver disease fibrosis metabolic dysfunction‐associated steatohepatitis protocol biopsy
ISSN:	0902-0063, 1399-0012, 1399-0012
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Abstract	ABSTRACT Background and Aims Metabolic dysfunction‐associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is unknown. Furthermore, the impact of the distinct cardiometabolic risk factors on histological disease activity has not been assessed. We aimed to evaluate the prevalence of dnMASLD and the association between the cardiometabolic risk factors and histological disease activity. Methods We performed a retrospective single‐center study in a LT cohort with indLbx and svLbx. Patients with NAFLD before LT were excluded. Results We analyzed 249 patients who underwent either svLbx or indLbx. Forty‐eight (19.2%) had either dnMASLD (n = 26/249, 10.4%) or metabolic dysfunction associated steatohepatitis (dnMASH) (n = 22/249, 8.8%). Although dnMASLD/dnMASH was more frequent in indLbx (35.1%, p < 0.01), still 16.5% of patients with svLbx had dnMASLD/dnMASH. While overweight (p < 0.01) and diabetes (p = 0.01) were more frequent in patients with dnMASH, only overweight was associated with histological disease activity in the multivariate analysis. No impact of dnMASLD on the overall survival was observed. Conclusion While dnMASLD is more frequent in patients with indLBX, it also occurs in 16.5% of patients without signs of graft dysfunction. Overweight has the strongest impact on histological disease activity and should be monitored carefully after LT.
AbstractList	ABSTRACT Background and Aims Metabolic dysfunction‐associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is unknown. Furthermore, the impact of the distinct cardiometabolic risk factors on histological disease activity has not been assessed. We aimed to evaluate the prevalence of dnMASLD and the association between the cardiometabolic risk factors and histological disease activity. Methods We performed a retrospective single‐center study in a LT cohort with indLbx and svLbx. Patients with NAFLD before LT were excluded. Results We analyzed 249 patients who underwent either svLbx or indLbx. Forty‐eight (19.2%) had either dnMASLD (n = 26/249, 10.4%) or metabolic dysfunction associated steatohepatitis (dnMASH) (n = 22/249, 8.8%). Although dnMASLD/dnMASH was more frequent in indLbx (35.1%, p < 0.01), still 16.5% of patients with svLbx had dnMASLD/dnMASH. While overweight (p < 0.01) and diabetes (p = 0.01) were more frequent in patients with dnMASH, only overweight was associated with histological disease activity in the multivariate analysis. No impact of dnMASLD on the overall survival was observed. Conclusion While dnMASLD is more frequent in patients with indLBX, it also occurs in 16.5% of patients without signs of graft dysfunction. Overweight has the strongest impact on histological disease activity and should be monitored carefully after LT. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is unknown. Furthermore, the impact of the distinct cardiometabolic risk factors on histological disease activity has not been assessed. We aimed to evaluate the prevalence of dnMASLD and the association between the cardiometabolic risk factors and histological disease activity.BACKGROUND AND AIMSMetabolic dysfunction-associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is unknown. Furthermore, the impact of the distinct cardiometabolic risk factors on histological disease activity has not been assessed. We aimed to evaluate the prevalence of dnMASLD and the association between the cardiometabolic risk factors and histological disease activity.We performed a retrospective single-center study in a LT cohort with indLbx and svLbx. Patients with NAFLD before LT were excluded.METHODSWe performed a retrospective single-center study in a LT cohort with indLbx and svLbx. Patients with NAFLD before LT were excluded.We analyzed 249 patients who underwent either svLbx or indLbx. Forty-eight (19.2%) had either dnMASLD (n = 26/249, 10.4%) or metabolic dysfunction associated steatohepatitis (dnMASH) (n = 22/249, 8.8%). Although dnMASLD/dnMASH was more frequent in indLbx (35.1%, p < 0.01), still 16.5% of patients with svLbx had dnMASLD/dnMASH. While overweight (p < 0.01) and diabetes (p = 0.01) were more frequent in patients with dnMASH, only overweight was associated with histological disease activity in the multivariate analysis. No impact of dnMASLD on the overall survival was observed.RESULTSWe analyzed 249 patients who underwent either svLbx or indLbx. Forty-eight (19.2%) had either dnMASLD (n = 26/249, 10.4%) or metabolic dysfunction associated steatohepatitis (dnMASH) (n = 22/249, 8.8%). Although dnMASLD/dnMASH was more frequent in indLbx (35.1%, p < 0.01), still 16.5% of patients with svLbx had dnMASLD/dnMASH. While overweight (p < 0.01) and diabetes (p = 0.01) were more frequent in patients with dnMASH, only overweight was associated with histological disease activity in the multivariate analysis. No impact of dnMASLD on the overall survival was observed.While dnMASLD is more frequent in patients with indLBX, it also occurs in 16.5% of patients without signs of graft dysfunction. Overweight has the strongest impact on histological disease activity and should be monitored carefully after LT.CONCLUSIONWhile dnMASLD is more frequent in patients with indLBX, it also occurs in 16.5% of patients without signs of graft dysfunction. Overweight has the strongest impact on histological disease activity and should be monitored carefully after LT. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is unknown. Furthermore, the impact of the distinct cardiometabolic risk factors on histological disease activity has not been assessed. We aimed to evaluate the prevalence of dnMASLD and the association between the cardiometabolic risk factors and histological disease activity. We performed a retrospective single-center study in a LT cohort with indLbx and svLbx. Patients with NAFLD before LT were excluded. We analyzed 249 patients who underwent either svLbx or indLbx. Forty-eight (19.2%) had either dnMASLD (n = 26/249, 10.4%) or metabolic dysfunction associated steatohepatitis (dnMASH) (n = 22/249, 8.8%). Although dnMASLD/dnMASH was more frequent in indLbx (35.1%, p < 0.01), still 16.5% of patients with svLbx had dnMASLD/dnMASH. While overweight (p < 0.01) and diabetes (p = 0.01) were more frequent in patients with dnMASH, only overweight was associated with histological disease activity in the multivariate analysis. No impact of dnMASLD on the overall survival was observed. While dnMASLD is more frequent in patients with indLBX, it also occurs in 16.5% of patients without signs of graft dysfunction. Overweight has the strongest impact on histological disease activity and should be monitored carefully after LT.
Author	Guetzlaff, Lea Jaeckel, Elmar Wedemeyer, Heiner Engel, Bastian Hartleben, Björn Taubert, Richard Bosselmann, Emily Campos‐Murguia, Alejandro Hupa‐Breier, Katharina Luise
AuthorAffiliation	1 Department of Gastroenterology Hepatology Infectious Diseases and Endocrinology Hannover Medical School Hannover Germany 3 Ajmera Transplant Centre Toronto General Hospital, United Health Network, University of Toronto Toronto Canada 2 Institut of Pathology, Hannover Medical School Hannover Germany
AuthorAffiliation_xml	– name: 3 Ajmera Transplant Centre Toronto General Hospital, United Health Network, University of Toronto Toronto Canada – name: 1 Department of Gastroenterology Hepatology Infectious Diseases and Endocrinology Hannover Medical School Hannover Germany – name: 2 Institut of Pathology, Hannover Medical School Hannover Germany
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Keywords	metabolic syndrome nonalcoholic fatty liver disease fibrosis metabolic dysfunction‐associated steatohepatitis protocol biopsy
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Notes	Katharina Hupa‐Breier and Bastian Engel were supported by the PRACTIS–Clinician Scientist Program of Hannover Medical School, funded by the German Research Foundation (DFG, ME 3696/3‐1). Alejandro Campos‐Murguia is supported by the DAAD Research Grants–One‐Year Grants for Doctoral Candidates, 2023/24 (57645447). Funding Alejandro Campos‐Murguia and Lea Guetzlaff contributed equally to this study. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Funding: Katharina Hupa‐Breier and Bastian Engel were supported by the PRACTIS–Clinician Scientist Program of Hannover Medical School, funded by the German Research Foundation (DFG, ME 3696/3‐1). Alejandro Campos‐Murguia is supported by the DAAD Research Grants–One‐Year Grants for Doctoral Candidates, 2023/24 (57645447).
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Snippet	ABSTRACT Background and Aims Metabolic dysfunction‐associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also... Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The...
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SubjectTerms	Adult Fatty Liver - etiology Fatty Liver - metabolism Fatty Liver - pathology Female fibrosis Follow-Up Studies Graft Survival Humans Liver Transplantation - adverse effects Male Metabolic Diseases - etiology Metabolic Diseases - pathology metabolic dysfunction‐associated steatohepatitis metabolic syndrome Middle Aged Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - etiology Non-alcoholic Fatty Liver Disease - metabolism Non-alcoholic Fatty Liver Disease - pathology nonalcoholic fatty liver disease Original Overweight - complications Postoperative Complications Prognosis protocol biopsy Retrospective Studies Risk Factors
Title	Overweight Impacts Histological Disease Activity of De Novo Metabolic Dysfunction‐Associated Steatotic Liver Disease After Liver Transplantation
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