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Villeret F, Dharancy S, Erard D, Abergel A, Barbier L, Besch C, Boillot O, Boudjema K, Coilly A, Conti F, Corpechot C, Duvoux C, Faitot F, Faure S, Francoz C, Giostra E, Gugenheim J, Hardwigsen J, Hilleret M, Hiriart J, Houssel‐Debry P, Kamar N, Lassailly G, Latournerie M, Pageaux G, Samuel D, Vanlemmens C, Saliba F, Dumortier J. Liver transplantation for NAFLD cirrhosis: Age and recent coronary angioplasty are major determinants of survival. Liver Int 2022; 42:2428-2441. [PMID: 35924452 PMCID: PMC9804523 DOI: 10.1111/liv.15385] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Liver transplantation (LT) is the treatment of end-stage non-alcoholic liver disease (NAFLD), that is decompensated cirrhosis and/or complicated by hepatocellular carcinoma (HCC). Few data on long-term outcome are available. The aim of this study was to evaluate overall patient and graft survivals and associated predictive factors. METHOD This retrospective multicentre study included adult transplant patients for NAFLD cirrhosis between 2000 and 2019 in participating French-speaking centres. RESULTS A total of 361 patients (69.8% of male) were included in 20 centres. The median age at LT was 62.3 years [57.4-65.9] and the median MELD score was 13.9 [9.1-21.3]; 51.8% of patients had HCC on liver explant. Between 2004 and 2018, the number of LT for NAFLD cirrhosis increased by 720%. A quarter of the patients had cardiovascular history before LT. Median follow-up after LT was 39.1 months [15.8-72.3]. Patient survival at 1, 5 and 10 years after LT was 89.3%, 79.8% and 68.1% respectively. The main causes of death were sepsis (37.5%), malignancies (29.2%) and cardiovascular events (22.2%). In multivariate analysis, three risk factors for overall mortality after LT were recipient pre-LT BMI < 32 kg/m2 at LT time (OR: 2.272; p = .012), pre-LT angioplasty during CV check-up (OR: 2.916; p = .016), a combined donor and recipient age over 135 years (OR: 2.020; 95%CI: p = .035). CONCLUSION Survival after LT for NAFLD cirrhosis is good at 5 years. Donor and recipient age, and cardiovascular history, are major prognostic factors to consider.
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Affiliation(s)
- François Villeret
- Service d'hépatologie et de transplantation hépatiqueHôpital de la Croix Rousse, Hospices Civils de LyonLyonFrance,Université Claude Bernard Lyon 1LyonFrance
| | - Sébastien Dharancy
- Service des Maladies de l'Appareil DigestifHôpital Claude Huriez, CHRU LilleLilleFrance
| | - Domitille Erard
- Service d'hépatologie et de transplantation hépatiqueHôpital de la Croix Rousse, Hospices Civils de LyonLyonFrance,Université Claude Bernard Lyon 1LyonFrance
| | - Armand Abergel
- Département de Médecine digestiveCHU EstaingClermont‐FerrandFrance
| | - Louise Barbier
- Service de chirurgie digestive, oncologique et Transplantation hépatiqueHôpital Trousseau, CHU ToursToursFrance
| | - Camille Besch
- Service de chirurgie hépato‐bilio‐pancréatique et transplantation hépatiqueCHRU HautepierreStrasbourgFrance
| | - Olivier Boillot
- Université Claude Bernard Lyon 1LyonFrance,Fédération des Spécialités DigestivesHôpital Edouard Herriot, Hospices civils de LyonLyonFrance
| | - Karim Boudjema
- Service de chirurgie hépatobiliaire et digestive et des maladies du foieHôpital Universitaire de PontchaillouRennesFrance
| | - Audrey Coilly
- Centre Hépato‐BiliaireHôpital Paul Brousse, AP‐HP, Université Paris Saclay, Unité Inserm 1193VillejuifFrance
| | - Filomena Conti
- Service de Chirurgie Digestive, Hépato‐Biliaire et de Transplantation HépatiqueHôpital Pitié Salpêtrière, AP‐HPParisFrance
| | | | | | - François Faitot
- Service de chirurgie hépato‐bilio‐pancréatique et transplantation hépatiqueCHRU HautepierreStrasbourgFrance
| | - Stéphanie Faure
- Département d'hépatologie et transplantation hépatiqueCHU Saint EloiMontpellierFrance
| | - Claire Francoz
- Service d'Hépatologie et Transplantation HépatiqueHôpital Beaujon, APHPClichyFrance
| | - Emiliano Giostra
- Service de Gastroentérologie et HépatologieHôpitaux Universitaires de GenèveGenèveSwitzerland
| | - Jean Gugenheim
- Service de Chirurgie Digestive et de Transplantation HépatiqueCHU Archet IINiceFrance
| | - Jean Hardwigsen
- Service chirurgie générale et transplantation hépatiqueHôpital La Timone, APHMMarseilleFrance
| | | | | | - Pauline Houssel‐Debry
- Service de chirurgie hépatobiliaire et digestive et des maladies du foieHôpital Universitaire de PontchaillouRennesFrance
| | - Nassim Kamar
- Département de Néphrologie et Transplantation d'OrganesCHU RangueilToulouseFrance
| | - Guillaume Lassailly
- Service des Maladies de l'Appareil DigestifHôpital Claude Huriez, CHRU LilleLilleFrance
| | | | | | - Didier Samuel
- Centre Hépato‐BiliaireHôpital Paul Brousse, AP‐HP, Université Paris Saclay, Unité Inserm 1193VillejuifFrance
| | - Claire Vanlemmens
- Service d'Hépatologie et Soins Intensifs DigestifsHôpital Jean MinjozBesançonFrance
| | - Faouzi Saliba
- Centre Hépato‐BiliaireHôpital Paul Brousse, AP‐HP, Université Paris Saclay, Unité Inserm 1193VillejuifFrance
| | - Jérôme Dumortier
- Université Claude Bernard Lyon 1LyonFrance,Fédération des Spécialités DigestivesHôpital Edouard Herriot, Hospices civils de LyonLyonFrance
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