Significant cohort of non-alcoholic fatty liver disease with portal vein thrombosis in transplant waiting list

doi:10.4254/wjh.v8.i7.376

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World Journal of Hepatology

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Retrospective Cohort Study

World J Hepatol. Mar 8, 2016; 8(7): 376-384
Published online Mar 8, 2016. doi: 10.4254/wjh.v8.i7.376

Significant cohort of non-alcoholic fatty liver disease with portal vein thrombosis in transplant waiting list

Metin Basaranoglu, Sonia M Najjar, Ali Ebag Demirbag, Hakan Senturk

Metin Basaranoglu, Hakan Sentur, Division of Gastroenterology, Department of Internal Medicine, Bezmialem Vakif University Faculty of Medicine, 34000 Fatih, Istanbul, Turkey

Metin Basaranoglu, Division of Gastroenterology, TürkiyeYüksek Ihtisas Hospital, 06010 Sihhiye, Ankara

Ali Ebag Demirbag, Division of Gastrointestinal Surgery, TürkiyeYüksek Ihtisas Hospital, 06010 Sihhiye, Ankara

Sonia M Najjar, Department of Physiology and Pharmacology, Center for Diabetes and Endocrine Research (CeDER), University of Toledo College of Medicine and Life Sciences, Toledo, OH 43614, United States

Author contributions: Basaranoglu M was involved in the study concept and design; study supervision, data acquisition, analysis and interpretation; drafting of the manuscript; critical revision of the manuscript for important intellectual content; raising fund; and providing administrative, technical, and material support; Demirbag AE performed statistical analysis; Najjar SM critically analyzed and reviewed data analysis and interpretation, and provided critical revision of the manuscript for important intellectual content; Sentürk H approved the final version of the manuscript.

Conflict-of-interest statement: The authors declare that they have no competing interests.

Data sharing statement: No additional data are available.

Correspondence to: Metin Basaranoglu, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Bezmialem Vakif University Faculty of Medicine, Adnan Menderes Bulvarı Vatan Caddesi, 34000 Fatih, Istanbul, Turkey. metin_basaranoglu@yahoo.com

Telephone: +90-212-5540000 Fax: +90-212-5540000

Received: November 15, 2015
Peer-review started: November 16, 2015
First decision: December 18, 2015
Revised: January 15, 2016
Accepted: February 23, 2016
Article in press: February 24, 2016
Published online: March 8, 2016
Processing time: 108 Days and 16.9 Hours

Abstract

AIM: To characterize non-alcoholic fatty liver disease (NAFLD) presentation with esophageal varices.

METHODS: We carried out a retrospective cohort study on 258 patients with esophageal varices at a single tertiary referral center. These patients underwent diagnosis of several liver diseases, including: NAFLD-associated cirrhosis, hepatitis B, hepatitis C, Wilson disease, autoimune liver diseases, and others.

RESULTS: Of the 258 patients, 39% of patients exhibited esophageal varices due to NAFLD-associated cirrhosis. Of the 38 (14.7%) patients developed hepatocellular carcinoma during follow-up, 52% were due to hepatitis B, 26% due to hepatitis C and 13.2% due to NAFLD. Of the 258 patients, 50.0% with NAFLD, 33.3% with hepatitis B, 26.3% with hepatitis C, and 58.3% with other diseases were alive at the end of the 5-year period with a significant difference according to the Kaplan-Meier log Rank test (P = 0.040). Portal vein thrombosis was detected in 47.5% of patients with NAFLD, in 29% of patients with hepatitis B, in 17% of patients with hepatitis C, and in 62% of patients with other related diseases (P < 0.0001).

CONCLUSION: Our study showed a proportionally greater elevation in liver transplant candidacy in patients with NAFLD and portal vein thrombosis. Older patients were more prone to developing cirrhosis, hepatocellular carcinoma and a high mortality rate. However, younger patients exhibited more portal vein thrombosis and gastric varices.

Keywords: Hepatocellular carcinoma; Non-alcoholic fatty liver disease; Portal vein thrombosis; Esophageal varices

Core tip: We aimed to characterize non-alcoholic fatty liver disease (NAFLD) presentation with esophageal varices. We carried out a retrospective cohort study on 258 patients with esophageal varices at a single tertiary referral center. Of the 258 patients, 39% exhibited esophageal varices due to NAFLD-associated cirrhosis. The incidence of portal vein thrombosis was 47.5% in patients with NAFLD, 29% in hepatitis B, 17% in hepatitis C, and 62% in patients with other related diseases (P < 0.0001). Our study showed a proportionally greater elevation in liver transplant candidacy in patients with NAFLD and portal vein thrombosis.