Conflict of interest: Dr. Chan W. Park has the following possible conflicts of interest to disclose: Currently assisting Transenterix, Inc. (Durham, NC) with creation of a national patient registry and database. Dr. Naoky T. Tsai has the following conflicts of interest to disclose: Research and Grant support: BMS, Genetech, Gilead, Novartis, Bayer, GSK, Vertex. Speakers bureau: BMS, Genetech, Gilead, Salix, Bayer, Three Rivers, GSK. Advisory board: BMS, Gilead, Three Rivers. Consultant: Salix. Dr. Linda L. Wong has the following conflict of interest to disclose: Speakers bureau for Bayer Healthcare. This original research was presented in a poster at the 2009 American Association for the Study of Liver Disease (AASLD) meeting in Boston, MA on October, 2009.
Implications of worse renal dysfunction and medical comorbidities in patients with NASH undergoing liver transplant evaluation: impact on MELD and more
Article first published online: 30 SEP 2011
© 2011 John Wiley & Sons A/S
Volume 25, Issue 6, pages E606–E611, November/December 2011
How to Cite
Park, C. W., Tsai, N. T. and Wong, L. L. (2011), Implications of worse renal dysfunction and medical comorbidities in patients with NASH undergoing liver transplant evaluation: impact on MELD and more. Clinical Transplantation, 25: E606–E611. doi: 10.1111/j.1399-0012.2011.01497.x
- Issue published online: 9 DEC 2011
- Article first published online: 30 SEP 2011
- Accepted for publication 13 May 2011
- model for end-stage liver disease score;
- non-alcoholic steatohepatitis;
- orthotopic liver transplant;
- post-transplant tumor;
- renal dysfunction;
- selection criteria
Park CW, Tsai NT, Wong LL. Implications of worse renal dysfunction and medical comorbidities in patients with NASH undergoing liver transplant evaluation: impact on MELD and more. Clin Transplant 2011: 25: E606–E611. © 2011 John Wiley & Sons A/S.
Abstract: Increasing numbers of patients with non-alcoholic steatohepatitis (NASH) are referred for liver transplant (LT). Our objective was to characterize patients with NASH among referred LT candidates (from 1998 to 2008), and we compared demographics, etiology of liver disease, diabetes, hypertension, smoking, obesity, cardiac disease, cancer, laboratory data, model for end-stage liver disease (MELD), and outcomes between NASH and non-NASH patients. Patients with NASH (n = 71) were compared to other chronic liver disease (n = 472). Patients with NASH were older (58.7 vs. 52.5 yr, p < 0.0001), Asian (53.5% vs. 34.7%, p = 0.03) and women (50.7% vs. 32.1%, p = 0.003). Patients with NASH had more diabetes, hypertension, obesity, cardiac disease, and smoking history (p < 0.05). Patients with NASH were equally likely to have liver cancer, but more likely to have non-liver cancers (20.8% vs. 4.4%, p = 0.008). There was no difference in MELD, but patients with NASH had lower protime/international normalized ratio (1.14 vs. 1.27, p = 0.04) and higher creatinine (1.26 vs. 0.98 mg/dL, p = 0.0018). Patients with NASH were equally likely to undergo evaluation, listing, and transplantation compared to non-NASH patients. While all patients with chronic liver disease can have renal dysfunction because of hepatorenal syndrome, patients with NASH have more renal dysfunction, perhaps related to diabetes, hypertension, and cardiovascular disease. Transplant centers should consider this carefully in selection of candidates for LT.