Liver transplantation for NASH cirrhosis is not performed at the expense of major post-operative morbidity

Background: Non-alcoholic steatohepatitis (NASH) is an emerging indication for liver transplantation (LT) and coexists with multiple comorbidities. Obese and cirrhotic patients experience more perioperative complications. Limited data exist about short-term complications after LT for NASH cirrhosis. Aim: Investigate short-term complications in patients transplanted for NASH cirrhosis. Methods: Single center retrospective cohort study including patients >18 years who underwent LT between 2009-2015. Exclusion criteria were LT for acute liver failure and non-cirrhotic disease. Post-operative complications and severity within 90-days were classified using the Clavien-Dindo classification of surgical complications and comprehensive complication index (CCI). P < 0.05 was significant. Results: Out of 169 eligible patients, 34 patients (20.1%) were transplanted for NASH cirrhosis. These patients were significantly older (59.2 vs. 54.8 years, P = 0.01), more obese (61.8% vs. 8.1%, P < 0.01), had more diabetes mellitus (73.5% vs. 20%, P < 0.01), metabolic syndrome (83.3% vs. 37.8%, P < 0.01) and cardiovascular disease (29.4% vs. 11.1%, P < 0.01). More grade 1 complications (OR 1.64, 95% CI 1.03-2.63, P = 0.04) and more grade 2 urogenital infections (OR 3.4, 95% CI 1.1-10.6, P = 0.03) were found. Major complications, CCI, 90-day mortality and graft survival were similar. Conclusion: Despite significantly increased comorbidities in patients transplanted for NASH cirrhosis, major morbidity, mortality and graft survival after 90 days were comparable to patients transplanted for other indications. (C) 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.