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ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 11 - 2024 |
doi: 10.3389/fmed.2024.1502055
This article is part of the Research Topic Hot Topics in Diabetes and Steatotic Liver Disease View all 6 articles
The impact of liver graft steatosis on long-term post-transplant hepatic steatosis and fibrosis via magnetic resonance quantification
Provisionally accepted
Lung Yi Mak
1,2
James Fung
1,2*
Gladys Lo
3*
Chrissy Lo
3*
Trevor Kwan-Hung Wu
1*
Matthew Shing-Hin Chung
1
Tiffany Cho-Lam Wong
1
Wai-Kay Seto
1,2
Albert Chi-Yan Chan
1,2
Man-Fung Yuen
1,2*- 1 The University of Hong Kong, Pokfulam, Hong Kong, SAR China
- 2 State Key Laboratory for Liver Research, LKS Faculty of Medicine, The University of Hong Kong, Hongkong, Hong Kong, SAR China
- 3 Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong, SAR China
Background: Due to the high prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), steatotic liver grafts (SLG) are increasingly encountered with uncertain implications on post liver transplant (LT) de novo hepatic steatosis (PTHS) and advanced fibrosis (≥F3). We aimed to characterize PTHS and ≥F3 by magnetic resonance imaging (MRI) in subjects who underwent LT for non-MASLD indications and examine the relationship with SLG. Methods: Post-LT subjects with data on implant biopsy fat content were recruited for MRI. MRI-proton density fat fraction (MRI-PDFF) and MR elastography (MRE) was performed using a 1.5 Tesla Optima 450W MR scanner with a 3D volumetric sequence. PTHS and ≥F3 was defined as MRI-PDFF ≥5% and MRE ≥3.64kPa, respectively. SLG was defined as implant biopsy fat ≥5%. Results: 292 subjects (70.5% male, median age at LT: 51.9, 22.6% had SLG) were recruited. The majority (73.6%) was transplanted for hepatitis B virus (HBV)-related complications. MRI was performed at a median time of 12.2 years post-LT and identified PTHS and ≥F3 in 27.4% and 10.6%, respectively. PTHS was independently associated with SLG (OR 2.067, 95% CI 1.082-3.951), central obesity (OR 3.952, 95% CI 1.768-8.832) and hypertension (OR 2.510, 95% CI 1.268-4.966). ≥F3 was associated with sex, change in BMI and abnormal liver biochemistry, but not PTHS or SLG. Conclusion: MRI identified a high prevalence of PTHS associated with SLG and metabolic risk factors among Chinese subjects transplanted for non-MASLD indications. Advanced graft fibrosis was not associated with PTHS nor SLG.
Keywords: MASLD, liver transplant, metabolic dysfunction, implant biopsy Aligos Therapeutics, AiCuris, Antios Therapeutics, Arbutus Biopharma, Arrowhead Pharmaceuticals
Received: 26 Sep 2024; Accepted: 10 Dec 2024.
Copyright: © 2024 Mak, Fung, Lo, Lo, Wu, Chung, Wong, Seto, Chan and Yuen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
James Fung, The University of Hong Kong, Pokfulam, Hong Kong, SAR China
Gladys Lo, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong, SAR China
Chrissy Lo, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong, SAR China
Trevor Kwan-Hung Wu, The University of Hong Kong, Pokfulam, Hong Kong, SAR China
Man-Fung Yuen, The University of Hong Kong, Pokfulam, Hong Kong, SAR China
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