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Impact of metabolic dysfunction-associated fatty liver disease on liver transplant recipients with hepatitis B virus-related hepatocellular carcinoma

European Journal of Clinical Nutrition volume 78, pages 107–113 (2024)Cite this article

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Abstract

Background

Metabolic dysfunction-associated fatty liver disease was proposed by international consensus to redefine the metabolic abnormal condition. However, its impact on liver transplant recipients with hepatitis B virus-related hepatocellular carcinoma has not been explored.

Methods

A two-center retrospective cohort study on liver transplant recipients with hepatitis B virus-related hepatocellular carcinoma was performed to analyze the impact of metabolic dysfunction-associated fatty liver disease on the clinicopathologic parameters and prognosis.

Results

There were 201 liver transplant recipients enrolled from two hospitals in our study. The pre- and post-transplant prevalences of metabolic dysfunction-associated fatty liver disease were 9.95% and 28.86%, respectively. The clinicopathological parameters revealed a similarity between patients with and without pre-transplant metabolic dysfunction-associated fatty liver disease. In contrast, the group with post-transplant metabolic dysfunction-associated fatty liver disease was linked with older age, a higher hepatitis recurrence rate and incidence of cardiovascular disease, usage of calcineurin inhibitors, a greater body mass index and waist circumference, lower albumin and high-density lipoprotein cholesterol levels, and poorer tumor-free survival and overall survival. The multivariate analysis showed the largest tumor size >4 cm (95% confidence intervals: 0.06~0.63, p = 0.006), microvascular invasion (95% confidence intervals: 1.61~14.92, p = 0.005), post-transplant metabolic dysfunction-associated fatty liver disease (95% confidence intervals: 1.40~10.60, p = 0.009), and calcineurin inhibitors-based regimen (95% confidence intervals: 0.33~0.96, p = 0.036) were the independent risk factors for recurrent hepatocellular carcinoma.

Conclusions

Our study suggests that post-transplant metabolic dysfunction-associated fatty liver disease is more closely to metabolic abnormalities and that it can help identify liver transplant recipients at high risk of recurrent hepatocellular carcinoma.

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Fig. 1: Overlap between pre- and post-transplant MAFLD.
Fig. 2: Comparison of TFS and OS between patients with and without MAFLD.
Fig. 3: Multivariate analysis of prognostic factors related to HCC recurrence.

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Data availability

All data generated or analyzed during this study are included in this article.

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Author information

Author notes

  1. These authors contributed equally: Ji-Qiao Zhu, Xiao-Yong Ye, Shi-Wei Yang.

Authors and Affiliations

  1. Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Organ Transplant Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China

    Ji-Qiao Zhu, Xiao-Yong Ye, Jia-Zong Liu, Zhang-Yong Ren, Ya-Nan Jia, Zhe Liu, Cheng Ding, Jian-Tao Kou, Xian-Liang Li & Qiang He

  2. Department of Hepatobiliary Surgery, China-Japan Friendship Hospital, Beijing, 100029, China

    Shi-Wei Yang & Dong-Dong Han

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Contributions

HDD and HQ contributed conception and design of the study; ZJQ, YXY, and YSW organized the database; RZY, LJZ, and JYN performed the analysis; LZ, DC, KJT, and LXL performed the follow-up and collected the data; ZJQ, YXY, and YSW wrote the first draft of the manuscript; the rest wrote and revised sections of the manuscript. All authors contributed to the manuscript revision, read and approved the submitted version.

Corresponding authors

Correspondence to Dong-Dong Han or Qiang He.

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The authors declare no competing interests.

Ethical approval

The study was approved by the Institutional Review Board of both hospitals in accordance with the 1964 Helsinki Declaration and its later amendments. Written informed consent from patients was waived since it was a retrospective study.

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Zhu, JQ., Ye, XY., Yang, SW. et al. Impact of metabolic dysfunction-associated fatty liver disease on liver transplant recipients with hepatitis B virus-related hepatocellular carcinoma. Eur J Clin Nutr 78, 107–113 (2024). https://doi.org/10.1038/s41430-023-01363-y

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