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).
“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.