Andrade Antônio Ricardo Cardia Ferraz de, Cotrim Helma P, Bittencourt Paulo L, Almeida Carolina G, Sorte Ney Christian Amaral Boa
Medicine and Health Graduate Program, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil.
Hospital Português, Salvador, BA, Brazil.
Rev Assoc Med Bras (1992). 2018 Feb;64(2):187-194. doi: 10.1590/1806-9282.64.02.187.
Nonalcoholic steatohepatitis (NASH) associated or not with cirrhosis is the third leading indication for liver transplantation (LT) around the world. After transplants, NASH has a high prevalence and occurs as both recurrent and de novo manifestations. De novo NASH can also occur in allografts of patients transplanted for non-NASH liver disease.
To evaluate recurrent or de novo NASH in post-LT patients.
A literature review was performed using search engines of indexed scientific material, including Medline (by PubMed), Scielo and Lilacs, to identify articles published in Portuguese and English until August 2016. Eligible studies included: place and year of publication, prevalence, clinical characteristics, risk factors and survival.
A total of 110 articles were identified and 63 were selected. Most of the studies evaluated recurrence and survival after LT. Survival reached 90-100% in 1 year and 52-100% in 5 years. Recurrence of NAFLD (steatosis) was described in 15-100% and NASH, in 4-71%. NAFLD and de novo NASH were observed in 18-67% and 3-17%, respectively. Metabolic syndrome, diabetes mellitus, dyslipidemia and hypertension were seen in 45-58%, 18-59%, 25-66% and 52-82%, respectively.
After liver transplants, patients present a high prevalence of recurrent and de novo NASH. They also show a high frequence of metabolic disorders. Nevertheless, these alterations seem not to influence patient survival.
非酒精性脂肪性肝炎（NASH）无论是否伴有肝硬化，都是全球肝移植（LT）的第三大主要适应症。移植后，NASH的患病率很高，可表现为复发和新发两种形式。新发NASH也可出现在因非NASH肝病接受移植患者的同种异体移植物中。
评估肝移植后患者复发性或新发NASH的情况。
使用索引科学资料搜索引擎进行文献综述，包括Medline（通过PubMed）、Scielo和Lilacs，以识别截至2016年8月以葡萄牙语和英语发表的文章。符合条件的研究包括：发表地点和年份、患病率、临床特征、危险因素和生存率。
共识别出110篇文章，筛选出63篇。大多数研究评估了肝移植后的复发情况和生存率。1年生存率达到90 - 100%，5年生存率达到52 - 100%。NAFLD（脂肪变性）的复发率为15 - 100%，NASH的复发率为4 - 71%。NAFLD和新发NASH的发生率分别为18 - 67%和3 - 17%。代谢综合征、糖尿病、血脂异常和高血压的发生率分别为45 - 58%、18 - 59%、25 - 66%和52 - 82%。
肝移植后，患者复发性和新发NASH的患病率很高。他们还表现出高频率的代谢紊乱。然而，这些改变似乎并不影响患者的生存率。
