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. 2020 May;20(3):313-318.
doi: 10.7861/clinmed.2019-0250.

Decompensated cirrhosis is the commonest presentation for NAFLD patients undergoing liver transplant assessment

Ahmed Hussain  1 , Preya J Patel  1 , Freya Rhodes  1 , Ankur Srivastava  1 , David Patch  1 , William Rosenberg  2
Affiliations

Decompensated cirrhosis is the commonest presentation for NAFLD patients undergoing liver transplant assessment

Ahmed Hussain et al. Clin Med (Lond). 2020 May.

Abstract

Non-alcoholic fatty liver disease (NAFLD) accounts for 10-15% of orthotopic liver transplants (OLTs) in the UK. Index presentations with cirrhotic decompensation represent missed opportunities for preventive treatment leaving OLT or palliation as the only options.We retrospectively reviewed patient records for all NAFLD patients undergoing assessment for OLT between January 2003 and December 2017.Data were available for 81 patients with NAFLD as the primary diagnosis. Fifty-two patients had decompensated cirrhosis at first presentation; 91.7% presented to secondary care compared to 52.7% referred from primary care (p=0.001). Cirrhosis was not suspected at the time of referral to hospital in 24.7% of patients subsequently assessed for OLT. Most patients undergoing assessment for OLT for NAFLD had decompensated cirrhosis at their first diagnosis of chronic liver disease. These data highlight the plight of patients with NAFLD cirrhosis in whom chronic liver disease is diagnosed late.

Keywords: Non-alcoholic fatty liver disease; cirrhosis; decompensation; prognosis; transplantation.

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Figures

Fig 1.
Fig 1.
Proportions of patients presenting to healthcare with decompensated disease.
Fig 2.
Fig 2.
Outcomes of transplant assessment.
Fig 3.
Fig 3.
Survival curve analysis for patients who underwent orthotopic liver transplant.
See this image and copyright information in PMC

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