RT Journal Article
SR Electronic
T1 Decompensated cirrhosis is the commonest presentation for NAFLD patients undergoing liver transplant assessment
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 313
OP 318
DO 10.7861/clinmed.2019-0250
VO 20
IS 3
A1 Ahmed Hussain
A1 Preya J Patel
A1 Freya Rhodes
A1 Ankur Srivastava
A1 David Patch
A1 William Rosenberg
YR 2020
UL http://www.rcpjournals.org/content/20/3/313.abstract
AB Non-alcoholic fatty liver disease (NAFLD) accounts for 10–15% of orthotopic liver transplants (OLTs) in the UK. Index presentations with cirrhotic decompensation represent missed opportunities for preventive treatment leaving OLT or palliation as the only options.We retrospectively reviewed patient records for all NAFLD patients undergoing assessment for OLT between January 2003 and December 2017.Data were available for 81 patients with NAFLD as the primary diagnosis. Fifty-two patients had decompensated cirrhosis at first presentation; 91.7% presented to secondary care compared to 52.7% referred from primary care (p=0.001). Cirrhosis was not suspected at the time of referral to hospital in 24.7% of patients subsequently assessed for OLT. Most patients undergoing assessment for OLT for NAFLD had decompensated cirrhosis at their first diagnosis of chronic liver disease. These data highlight the plight of patients with NAFLD cirrhosis in whom chronic liver disease is diagnosed late.