Outcomes of Non-Alcoholic Steatohepatitis Patients After Liver Transplantation: A Systematic Review and Meta-Analysis

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Context: Non-alcoholic steatohepatitis (NASH) has become a prevalent disease worldwide as well as a leading cause for liver transplantation in the next decades. Thus the purpose of this review is to evaluate the outcomes of NASH patients after liver transplantation in comparison to non-NASH patients. Evidence Acquisition: Studies published in English before February 2018 were retrieved through literature searches in PubMed, Web of Science, Wiley Online Library, Research Gate, and EMBASE. Studies that compared the outcomes of liver transplantation for NASH and other liver diseases were eligible. Results: A total of 13 studies were included in the current study. Compared with non-NASH group, NASH patients presented higher mortality after liver transplantation in 1 and 2 years, which might associate with recipient age, sex, diabetes, and hypertension. However, the 3- and 5-year survival were similar between the two groups. Infection was the most prevalent etiology of mortality in NASH group. Conclusions: The NASH patients receiving liver transplantation presented higher mortality in the first two years and infectious complications were fatal for them. Therefore, more attention should be paid on NASH patients with infections, especially in the first and second year after the transplantation.