De Novo Non-Alcoholic Fatty Liver Disease Following Orthotopic Liver Transplantation

Fred Poordad, Robert Gish, Adil Wakil, Richard Garcia-Kennedy, Paul Martin, Francis Y. Yao

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognized clinico-pathologic entity typically associated with obesity, type II diabetes and hyperlipidemia. It has been noted to recur after orthotopic liver transplantation (OLT). We report four patients who developed de novo NAFLD within 3 months of OLT without the typical predisposing factors of diabetes mellitus or obesity. Three of the four patients underwent OLT for hepatitis C-related cirrhosis, and the other for alcoholic cirrhosis. Examination of the liver explants revealed no evidence of steatosis. No surreptitious alcohol use or a drug-induced process could be identified in these patients. Treatment of recurrent hepatitis C infection in one patient with interferon and ribavirin led to sustained suppression of the viral RNA to undetectable levels, but no improvement in histology or liver enzymes. All four patients had histologic evidence of preservation injury on the initial post-OLT biopsies, but the significance of this finding in relationship to the development of NAFLD is unknown. NAFLD can develop without any of the known predisposing conditions after transplantation, and this raises further questions about the pathogenesis of this condition.

Original languageEnglish (US)
Pages (from-to)1413-1417
Number of pages5
JournalAmerican Journal of Transplantation
Issue number11
StatePublished - Nov 2003
Externally publishedYes


  • Liver transplantation
  • NAFLD (nonalcoholic fatty liver disease)
  • NASH (non-alcoholic steatohepatitis)
  • Steatosis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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