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Liver transplant required for NAFLD ?

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Hello everyone, my name is Mark and I was diagnosed with NAFLD about 3 years ago. I also have Type II diabetes and IBS. I have been having my bloodwork checked just about every 3 months by my family doctor and my ALT, which has been high for the last 2-3 years (between 80-90) has been higher in the past 6 months (110-120). My gastro ran a set of blood tests and all of the bloodwork (Hep A, B and C etc.) came back OK but my ALT is still between 110-120. I am very scared because I called the office for my blood results and I talked to his PA because he was not in and she mentioned possibly having a biopsy done. I asked her what the worst case scenario is and she mentioned a liver transplant. I cant even think straight right now with the thought of having something like that. What do you think the chances are of having something this serious? I had 2 ultrasounds done in the past year and a half and he never mentioned anything worse than NAFDL.

PLEASE HELP!!!!!


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replied May 7th, 2010
Liver Disorders, Hepatitis A,B,C Answer A11816
Hello Mark, welcome to the ehealth forum and I am glad to help you.
You seem concerned by the diagnosis of NAFLD and elevated aminotransferase levels. You have also made a mention of Type 2 Diabetes Mellitus, obesity and the use of alcohol(beer)for the last 20 years.
Most patients with NAFLD are asymptomatic. Abnormal liver function test results(elevated aminotransferases) are usually the first sign of a disorder. The serum transaminase levels are usually not greatly elevated, but in contrast with alcoholic liver disease, the alanine aminotransferase (ALT) level will be higher than the aspartate aminotransferase (AST) level. Nonalcoholic fatty liver disease(NAFLD), therefore, is simply fat deposition in the liver that is not caused by chronic ingestion of alcohol. At one extreme is fatty liver occurring without inflammation; at the other is cirrhosis. Nonalcoholic steatohepatitis(NASH) is an intermediate disease state between these two extremes.
NAFLD is believed to be the most common cause of cryptogenic cirrhosis but that in itself is rare. Because NAFLD is a benign condition in most patients, biopsy is reserved only for those who are most likely to have fibrosis. A recent study has suggested that old age, obesity, and diabetes mellitus increase the chance of fibrosis being found on examination of liver biopsy specimens. So, you qualify as a candidate for liver biopsy.
Treatment of NAFLD focuses on judicious weight loss, abstention from alcohol, control of diabetes, and treatment of dyslipidemia. But how effective is this in controlling the disease is unclear .If cryptogenic cirrhosis has developed(though it is rare as NAFLD usually follows silent benign course without progression), then liver transplantation is the only option left.
Hope this helps. Take care.
Note: This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.




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