Non-alcoholic steatohepatitis and obesity at 1 year– modifiable predictors of metabolic outcomes in liver recipients
Metabolic complications (MC) are a recognized health concern in liver transplant (LT) recipients that result in inferior patient-reported outcomes. The aim of this study was to investigate the incidence, time to onset and predictors of MC in LT recipients. Patients who received a cadaveric-donor-liver transplant between 2010 and 2019 were eligible. Adapted International Diabetes Federation, American Heart Association and the National Heart, Lung, and Blood Institute guidelines were utilised for metabolic syndrome (MS) diagnosis. 282 patients were enrolled with a median age of 52 years (66.7% males). Non-alcoholic steatohepatitis led to LT in 8.2 % of cases. De-novo MS was diagnosed in 36% of the study population. Patients with NASH presented unfavourable metabolic profiles before and after the transplant. Patients with and without NASH predominantly shared the same weight gain pattern. The NASH aetiology (OR: 5.5; p5% CI: 1.624-22.868; p =0.010), higher BMI at 1-year post-transplant (OR: 1.321; 95% CI: 1.214-1.449; p=<0.001), and older age at transplant (OR: 1.038; 95% CI: 1.006-1.074; p=0.022) were independently associated with new-onset MS in liver recipients. Concluding, MC were prevalent in liver recipients. The NASH aetiology, higher BMI at 1-year and older age at transplant were risk factors of new-onset MS.