| International Session（Symposium）1(JSH・JSGE・JSGCS) |
| Thu. November 5th 9:00 - 11:20 Room 5: Portopia Hotel South Wing Ohwada A |
| Clinical aspects of liver cirrhosis due to NAFLD: Risk prediction and liver transplantation in US Midwest | |||
| Tomohiro Tanaka1, Antonio Sanchez1, Arvind R. Murali1 | |||
| 1University of Iowa Carver College of Medicine | |||
|
|||
|
|||
| Background: Predicting the probability of development of hepatic events (decompensation) and the subsequent treatment including liver transplant (LT) in a NAFLD patient is critical. Methods: We evaluated patients with NAFLD without cirrhosis at baseline (2000-2016) and a separate sample which included all the LT candidates in our center (2010-2019). Results: Of the 700 patients with NAFLD without cirrhosis, 49 (7%) developed a hepatic event at a mean follow up of 6.1±4.0 years. The probability of development of hepatic events at 5 and 10 years was 4.8% and 10.7%, respectively. Multivariate analysis of construction cohort (n=450) identified - age, presence of diabetes mellitus (DM) and platelet count as independent predictors of developing hepatic events. A predictive model incorporating those factors was constructed: 0.059139*age+0.789073*DM-0.000013*platelet count-3.06021. This model was tested in the validation cohort (n=250) and had an AUROC of 0.85 (p<0.001). Among the 276 who were evaluated for liver transplantation, 42% (n=120) were waitlisted, of which 70% (n=84) received LT at a median MELD score of 22 (10-40). The post-transplant survival was feasible, with 1- and 5-year overall survival of 95% and 88%, respectively. Conclusions: A significant proportion of patients with NAFLD develop hepatic decompensation. We have provided a simple, objective model to help identify ‘at-risk’ patients. For those with end-stage liver disease, LT offers a decent outcome for those with NAFLD. |
|||
|
Index Term 1: Risk prediction Index Term 2: Liver Transplantation |
|||
| Page Top | |||