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Abstract：
Objective The course of cryptogenic cirrhosis (CC) after liver transplantation (LT) is unknown. We therefore clarified the natural course post-LT for CC and investigated the etiology of CC. Methods Eighteen patients who underwent LT for CC were included. To rule out the possibility of nonalcoholic steatohepatitis (NASH) in patients with CC, those with a history of obesity or liver steatosis found pretransplantation were excluded. A liver biopsy was performed one year after LT and annually thereafter. Results Liver steatosis and steatohepatitis were identified in 61% and 39% of patients after LT, respectively, with a median time to the onset of 12 and 27 months, respectively. There were no other pathological findings such as liver allograft rejection, autoimmune hepatitis, or primary biliary cholangitis. The body mass index after LT (28.5 vs. 22.4 kg/m2; p=0.002) and mean muscle attenuation at the time of LT were significantly higher (33.3 vs. 25.8 Hounsfield units, p=0.03) and the postoperative hospitalization period shorter (50 vs. 102 days; p=0.02) in the steatosis group than in the non-steatosis group. Recipients were significantly younger in the steatohepatitis subgroup than in the simple steatosis subgroup (55.0 vs. 63.5 years old; p=0.04). Conclusion Despite excluding CC patients with a history of obesity, we observed that patients with CC had a high prevalence of steatosis after LT than those without CC. Young patients with a favorable postoperative course were noted to have a high risk of NASH after LT for CC. Patients with CC may represent cases of non-obese NASH.
摘要：
目的肝移植（LT）后隐源性肝硬化（CC）的病程未知。因此，我们阐明了CC的LT后自然病程，并研究了CC的病因。方法纳入18例接受肝移植治疗的CC患者。为了排除CC患者发生NASH的可能性，移植前发现有肥胖或肝脏脂肪变性病史的患者被排除.肝移植后一年和此后每年进行肝活检。结果肝脂肪变性和脂肪性肝炎在肝移植后的61％和39％的患者被发现，分别,发病的中位时间为12个月和27个月，分别。没有其他病理发现，如肝脏移植排斥反应，自身免疫性肝炎，或原发性胆汁性胆管炎.LT后的体重指数（28.5vs.22.4kg/m2；P=0.002）和LT时的平均肌肉衰减明显更高（33.3vs.25.8Hounsfield单位，P=0.03），术后住院时间更短（50vs.102天；P=0.02）在脂肪变性组高于非脂肪变性组。脂肪性肝炎亚组的受者比单纯脂肪变性亚组的受者年轻得多（55.0vs.63.5岁；P=0.04）。结论尽管排除了有肥胖史的CC患者，我们观察到有CC的患者在LT术后脂肪变性的患病率高于无CC的患者.术后病程良好的年轻患者在接受CC的LT后发生NASH的风险很高。CC患者可能代表非肥胖NASH病例。
