Published online May 28, 2016. doi: 10.4254/wjh.v8.i15.659
Peer-review started: January 25, 2016
First decision: February 29, 2016
Revised: March 30, 2016
Accepted: May 7, 2016
Article in press: May 9, 2016
Published online: May 28, 2016
Non-alcoholic fatty liver disease (NAFLD) is a recognized problem in patients after orthotopic liver transplantation and may lead to recurrent graft injury. As the increased demand for liver allografts fail to match the available supply of donor organs, split liver transplantation (SLT) has emerged as an important technique to increase the supply of liver grafts. SLT allows two transplants to occur from one donor organ, and provides a unique model for observing the pathogenesis of NAFLD with respect to the role of recipient environmental and genetic factors. Here we report on two recipients of a SLT from the same deceased donor where only one developed non-alcoholic steatohepatitis (NASH), suggesting that host factors are critical for the development of NASH.
Core tip: Split liver transplantation provides a unique model of the pathogenesis of non-alcoholic fatty liver disease with respect to the role of recipient environmental risk factors and genetic background because the same donor graft is shared by two distinct recipients. Here we present two recipients of a split liver transplantation from same deceased donor, with one developing nonalcoholic steatohepatitis and the other without any evidence of hepatic steatosis three years after they were transplanted. These cases provide a unique natural experiment to explore host factors that contributed to the development of nonalcoholic steatohepatitis after liver transplantation.