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Abstract：
Non-alcoholic fatty liver disease (NAFLD), specifically its progressive form non-alcoholic steatohepatitis (NASH), represents the fastest growing indication for liver transplantation in Western countries. Diabetes mellitus, morbid obesity and cardiovascular disease are frequently present in patients with NAFLD who are candidates for liver transplantation. These factors require specific evaluation, including a detailed pre-surgical risk stratification, in order to improve outcomes after liver transplantation. Moreover, in the post-transplantation setting, the incidence of cardiovascular events and metabolic complications can be amplified by immunosuppressive therapy, which is a well-known driver of metabolic alterations. Indeed, patients with NASH are more prone to developing early post-transplant complications and, in the long-term, de novo malignancy and cardiovascular events, corresponding to higher mortality rates. Therefore, a tailored multidisciplinary approach is required for these patients, both before and after liver transplantation. Appropriate candidate selection, lifestyle modifications and specific assessment in the pre-transplant setting, as well as pharmacological strategies, adjustment of immunosuppression and a healthy lifestyle in the post-transplant setting, play a key role in correct management.
摘要：
非酒精性脂肪性肝病（NAFLD），特别是其进行性非酒精性脂肪性肝炎（NASH），是西方国家肝移植发展最快的适应症。糖尿病,可接受肝移植的NAFLD患者常出现病态肥胖和心血管疾病.这些因素需要具体评估，包括详细的术前风险分层，以改善肝移植后的预后。此外，在移植后的环境中，免疫抑制治疗可以放大心血管事件和代谢并发症的发生率，这是众所周知的代谢改变的驱动因素。的确,NASH患者更容易出现移植后早期并发症，从长远来看,从头恶性肿瘤和心血管事件，对应于较高的死亡率。因此,这些患者需要量身定制的多学科方法，肝移植前后。适当的候选人选择，移植前环境中的生活方式改变和具体评估，以及药理学策略，在移植后环境中调整免疫抑制和健康的生活方式，在正确管理中发挥关键作用。
