Liver transplantation (LT) for metabolic dysfunction-associated steatotic liver disease (MASLD) is challenging due to high comorbidity rates, including obesity, diabetes, and hypertension. These factors impact pre-transplant evaluations, surgical outcomes, and post-transplant monitoring. Patients with MASLD often have higher BMI and a greater risk of cardiovascular events and metabolic syndrome, requiring comprehensive management. As MASLD becomes a more common indication for LT, associated complications, such as steatosis recurrence and cardiovascular disease, necessitate careful long-term monitoring.

Post-transplant complications in patients with MASLD include higher risks of metabolic syndrome, cardiovascular events, and renal issues. While overall survival rates are similar to those with other liver diseases, cardiovascular morbidity is notably higher. Bariatric surgery (BS) could help manage weight and metabolic disorders, but the timing of BS remains unclear. A multidisciplinary approach, with thorough pre-transplant assessments, intraoperative care, and ongoing post-transplant management, is essential to optimize outcomes and ensure long-term health.

Reference: Sato-Espinoza K, Chotiprasidhi P, Liza E, et al. Evolution of liver transplantation in the metabolic dysfunction-associated steatotic liver disease era: Tracking impact through time. World J Transplant. 2024 Dec 18;14(4):98718. doi: 10.5500/wjt.v14.i4.98718. PMID: 39697455; PMCID: PMC11438936.