A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to Diagnosis
Despite advances in posttransplant care, long-term outcomes for liver transplant recipients remain unchanged. Approximately 25% of recipients will advance to graft cirrhosis and require retransplantation. Graft fibrosis progresses in the context of de novo or recurrent disease. Recurrent hepatitis C...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-11-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001547 |
| _version_ | 1797449528209571840 |
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| author | Madhumitha Rabindranath, HBSc Rita Zaya, MD Khairunnadiya Prayitno, PhD Ani Orchanian-Cheff, MISt Keyur Patel, MD, PhD Elmar Jaeckel, MD Mamatha Bhat, MD, PhD |
| author_facet | Madhumitha Rabindranath, HBSc Rita Zaya, MD Khairunnadiya Prayitno, PhD Ani Orchanian-Cheff, MISt Keyur Patel, MD, PhD Elmar Jaeckel, MD Mamatha Bhat, MD, PhD |
| author_sort | Madhumitha Rabindranath, HBSc |
| collection | DOAJ |
| description | Despite advances in posttransplant care, long-term outcomes for liver transplant recipients remain unchanged. Approximately 25% of recipients will advance to graft cirrhosis and require retransplantation. Graft fibrosis progresses in the context of de novo or recurrent disease. Recurrent hepatitis C virus infection was previously the most important cause of graft failure but is now curable in the majority of patients. However, with an increasing prevalence of obesity and diabetes and nonalcoholic fatty liver disease as the most rapidly increasing indication for liver transplantation, metabolic dysfunction-associated liver injury is anticipated to become an important cause of graft fibrosis alongside alloimmune hepatitis and alcoholic liver disease.
To better understand the landscape of the graft fibrosis literature, we summarize the associated epidemiology, cause, potential mechanisms, diagnosis, and complications. We additionally highlight the need for better noninvasive methods to ameliorate the management of graft fibrosis. Some examples include leveraging the microbiome, genetic, and machine learning methods to address these limitations. Overall, graft fibrosis is routinely seen by transplant clinicians, but it requires a better understanding of its underlying biology and contributors that can help inform diagnostic and therapeutic practices. |
| first_indexed | 2024-03-09T14:26:16Z |
| format | Article |
| id | doaj.art-e16bf567304e420db4ef3b2d2763957e |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-03-09T14:26:16Z |
| publishDate | 2023-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-e16bf567304e420db4ef3b2d2763957e2023-11-28T07:14:05ZengWolters KluwerTransplantation Direct2373-87312023-11-01911e154710.1097/TXD.0000000000001547202311000-00006A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to DiagnosisMadhumitha Rabindranath, HBSc0Rita Zaya, MD1Khairunnadiya Prayitno, PhD2Ani Orchanian-Cheff, MISt3Keyur Patel, MD, PhD4Elmar Jaeckel, MD5Mamatha Bhat, MD, PhD61 Ajmera Transplant Program, University Health Network, Toronto, ON, Canada.1 Ajmera Transplant Program, University Health Network, Toronto, ON, Canada.1 Ajmera Transplant Program, University Health Network, Toronto, ON, Canada.4 Library and Information Services, University Health Network, Toronto, ON, Canada.5 Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Ajmera Transplant Program, University Health Network, Toronto, ON, Canada.1 Ajmera Transplant Program, University Health Network, Toronto, ON, Canada.Despite advances in posttransplant care, long-term outcomes for liver transplant recipients remain unchanged. Approximately 25% of recipients will advance to graft cirrhosis and require retransplantation. Graft fibrosis progresses in the context of de novo or recurrent disease. Recurrent hepatitis C virus infection was previously the most important cause of graft failure but is now curable in the majority of patients. However, with an increasing prevalence of obesity and diabetes and nonalcoholic fatty liver disease as the most rapidly increasing indication for liver transplantation, metabolic dysfunction-associated liver injury is anticipated to become an important cause of graft fibrosis alongside alloimmune hepatitis and alcoholic liver disease. To better understand the landscape of the graft fibrosis literature, we summarize the associated epidemiology, cause, potential mechanisms, diagnosis, and complications. We additionally highlight the need for better noninvasive methods to ameliorate the management of graft fibrosis. Some examples include leveraging the microbiome, genetic, and machine learning methods to address these limitations. Overall, graft fibrosis is routinely seen by transplant clinicians, but it requires a better understanding of its underlying biology and contributors that can help inform diagnostic and therapeutic practices.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001547 |
| spellingShingle | Madhumitha Rabindranath, HBSc Rita Zaya, MD Khairunnadiya Prayitno, PhD Ani Orchanian-Cheff, MISt Keyur Patel, MD, PhD Elmar Jaeckel, MD Mamatha Bhat, MD, PhD A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to Diagnosis Transplantation Direct |
| title | A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to Diagnosis |
| title_full | A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to Diagnosis |
| title_fullStr | A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to Diagnosis |
| title_full_unstemmed | A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to Diagnosis |
| title_short | A Comprehensive Review of Liver Allograft Fibrosis and Steatosis: From Cause to Diagnosis |
| title_sort | comprehensive review of liver allograft fibrosis and steatosis from cause to diagnosis |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001547 |
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