https://www.ncbi.nlm.nih.gov/pubmed/30335699 NAFLD

Transplantation. 2018 Oct 31. doi: 10.1097/TP.0000000000002490. [Epub ahead of print]
NAFLD and liver transplantation in children - Working group report from the ILTS single topic conference on NAFLD.
Cananzi M1, Vajro P2, Rela M3, Dhawan A4.

Abstract

BACKGROUND:
NAFLD has now become a common cause of chronic liver disease in children, however unlike adults liver transplantation is rarely required as treatment. It is important that in children presenting with NAFLD, secondary causes of fatty liver particularly inherited metabolic defects should be excluded.

METHODS:
A pediatric working group comprised of 3 hepatologists and a liver transplant surgeon was tasked with a set of questions to address the current state of evidence and knowledge about NAFLD in children with particular focus on liver transplantation. A systematic review of the English literature regarding pediatric NAFLD (from birth to 18 years of age) published in the last 2 decades (2000-2018) was carried out. The evidence was evaluated by the subgroup members and further discussed with the wider workshop faculty leading to the recommendations for best practice.

RESULTS:
Given the paucity of literature on the subject good quality of evidence was only available on risk factors for NAFLD and medical treatment where the group could make recommendation with high/moderate strength. The evidence on natural history and indications for liver transplantation was poor hence group couldn't make any recommendations.

CONCLUSIONS:
Based on the existing literature and subgroups collective experience NAFLD unlike adults is a very rare indication for liver transplantation in children. No definitive recommendations could be made about the natural history, indications and outcome of liver transplantation for NAFLD in children.