Recurrent or De Novo Allograft Steatosis and Long-Term Outcomes After Liver Transplantation

Background Hepatic steatosis is strongly associated with cardiovascular disease in the general population. Whether recurrent or de novo, it can occur in the allograft but the impact on survival and long term clinical outcomes remains unclear. In this study, we aim to determine both the frequency and impact of allograft steatosis on long term posttransplant outcomes. Methods A retrospective review of 588 adult liver transplant (LT) recipients (1999-2006) was performed. Cox regression analysis (time dependent) was used to evaluate differences in time to steatosis post-LT, patient survival and cardiovascular outcomes. Results Mean age 51.9±10.6 years, 64.6% males, underlying NASH (9.4%), previous tobacco (52%), pre-LT diabetes mellitus (30.3%), pre-LT hypertension (23.2%), and known cardiovascular disease (9.7%). Overall, 254 recipients developed allograft steatosis (at 10 years: 77.6% NASH recipients, 44.7% Non-NASH recipients). Risk factors for allograft steatosis were female gender (hazard ratio [HR] 1.47, 95% confidence interval [CI] 1.09-2.00, p=0.014), HCV diagnosis (HR 2.49, 95% CI 1.77-3.94, p

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