HealthDay News — Nonoverweight patients with nonalcoholic fatty liver disease (NAFLD) cirrhosis who are on the transplant wait list have worse pre- and post-liver transplant (LT) outcomes, according to a study presented at The Liver Meeting, the annual meeting of the American Association for the Study of Liver Diseases, held virtually from Nov. 12 to 15.

Pedro Ochoa-Allemant, M.D., from Yale School of Medicine in New Haven, Connecticut, and colleagues evaluated the associations of nonoverweight NAFLD and diabetes with adverse wait-list removal and post-LT all-cause mortality. The analysis included 24,127 adult patients with NAFLD (nonoverweight, 6.8 percent; overweight/obese, 93.2 percent) listed for LT on the United Network for Organ Sharing database (Feb. 27, 2002, to June 30, 2020).

The researchers found that nonoverweight patients had higher wait-list removal (subdistribution hazard ratio [SHR], 1.14) and all-cause mortality after LT (HR, 1.50) versus overweight/obese patients. Nonoverweight patients with diabetes had higher wait-list removal (SHR, 1.29) and all-cause mortality after LT (HR, 1.95) compared with overweight/obese patients without diabetes. In a multivariable analysis, nonoverweight patients with diabetes had higher wait-list removal (SHR, 1.18), while nonoverweight patients, with and without diabetes, had higher post-LT mortality (HRs, 1.84 and 1.47, respectively).

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“Optimizing metabolic risks in nonoverweight NAFLD patients with diabetes through appropriate nutritional counseling and lifestyle intervention may help mitigate poor outcomes on the transplant waitlist,” the authors write.

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