{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T07:32:57Z","timestamp":1768894377429,"version":"3.49.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>NAFLD can occur after liver transplantation (LT), as recurrence or <jats:italic toggle=\"yes\">de novo<\/jats:italic> hepatic steatosis (HS). We aimed to evaluate the literature on prevalence, risk factors, and prognosis of post-LT HS. Systematic review with meta-analysis through a search on: PUBMED, Scopus, and Web-of-Science, from inception until the September 30, 2021. Forty studies were included, representing 6979 patients. The post-LT HS prevalence was 39.76% (95% CI, 34.06\u201345.46), with a rising kinetics (11.06% increase per decade, <jats:italic toggle=\"yes\">p<\/jats:italic>=0.04), and a geographical distribution (15.10% more prevalent in American continent compared with Europe and Asia). Recurrent HS was up to 5-fold more likely than <jats:italic toggle=\"yes\">de novo<\/jats:italic> HS [OR: 5.38 (2.69\u201310.76)]. Metabolic disturbances were stronger risk factors in the post-LT recipient [obesity: OR: 4.62 (3.07\u20136.96); metabolic syndrome: OR: 3.26 (2.03\u20135.25)] as compared with pre-LT recipients, with the exception of diabetes mellitus, which doubled the risk at any set [pre-LT diabetes mellitus: OR: 2.06 (1.58\u20132.68); post-LT diabetes mellitus: OR: 2.12 (1.73\u20132.59)]. Donor factors were not the relevant risk factors for post-LT HS and the only immunosuppressive drug associated with increased risk was sirolimus [OR: 1.68 (1.07\u20132.64)]. The prevalence of post-LT steatohepatitis was 28.82% (19.62\u201338.03) and the strongest risk factor was pre-LT NAFLD. Limited outcomes data suggest that post-LT HS did not increase the risk for liver cirrhosis or mortality in these studies. Two out of 5 patients submitted to LT will develop post-LT HS, being recurrent HS more common than <jats:italic toggle=\"yes\">de novo<\/jats:italic> HS. Diabetes mellitus and post-LT metabolic syndrome are the strongest risk factors for HS and baseline NAFLD for steatohepatitis. All transplanted patients should be enrolled in lifestyle interventions to prevent post-LT metabolic syndrome, and sirolimus should be avoided in high-risk patients.<\/jats:p>","DOI":"10.1097\/lvt.0000000000000060","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T12:46:05Z","timestamp":1675428365000},"page":"431-448","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":27,"title":["Hepatic steatosis after liver transplantation: a systematic review and meta-analysis"],"prefix":"10.1097","volume":"29","author":[{"given":"Ana C.","family":"Silva","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Medicine School, Lisbon University, Lisbon, Portugal"}]},{"given":"Paulo","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Biostatistic Department, Medicine School, Lisbon University, Lisbon, Portugal"}]},{"given":"Mariana V.","family":"Machado","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Medicine School, Lisbon University, Lisbon, Portugal"},{"name":"Gastroenterology Department, Vila Franca de Xira Hospital, Lisbon, Portugal"}]}],"member":"276","published-online":{"date-parts":[[2023,1,3]]},"reference":[{"key":"R1-20250824","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1111\/apt.17158","article-title":"Review article: the epidemiologic burden of non-alcoholic fatty liver disease across the world","volume":"56","author":"Henry","year":"2022","journal-title":"Aliment Pharmacol Ther"},{"key":"R2-20250824","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1002\/hep4.1915","article-title":"Nonalcoholic steatohepatitis is the most common indication for liver transplantation among the elderly: data from the United States Scientific Registry of Transplant Recipients","volume":"6","author":"Stepanova","year":"2022","journal-title":"Hepatol Commun"},{"key":"R3-20250824","doi-asserted-by":"crossref","first-page":"e345","DOI":"10.1097\/TP.0000000000002916","article-title":"Incidence and risks for nonalcoholic fatty liver disease and steatohepatitis post-liver transplant: systematic review and meta-analysis","volume":"103","author":"Saeed","year":"2019","journal-title":"Transplantation"},{"key":"R4-20250824","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1590\/1806-9282.64.02.187","article-title":"NCAB. 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