Language

English

Publication Date

5-1-2025

Journal

American Journal of Transplantation

DOI

10.1016/j.ajt.2025.01.002

PMID

39793899

Abstract

The association between hypopituitarism and metabolic dysfunction-associated steatotic liver disease is increasingly recognized, although data about therapies targeting recurrence posttransplant is limited. An 8-year-old with hypopituitarism-associated metabolic dysfunction-associated steatotic liver disease underwent a liver transplant due to rapid progression of metabolic dysfunction-associated steatohepatitis. Hepatosteatosis recurred within weeks. Her therapeutic plan included a glucagon-like peptide-1 agonist and growth hormone replacement. Her transaminases normalized in 2.5 months, and her macrosteatosis significantly improved on the 1-year surveillance biopsy. This case highlights one of the youngest reported children with hypopituitarism to have undergone transplantation for rapidly progressing metabolic dysfunction-associated steatohepatitis and its recurrence post-operatively. We observed that steatosis improved with growth hormone replacement and glucagon-like peptide-1 agonist therapy. If started early, this combination could help delay recurrence of steatosis post-transplantation. Further research is needed to determine long-term effects and establish protocols.

Keywords

Humans, Female, Hypopituitarism, Child, Liver Transplantation, Fatty Liver, Glucagon-Like Peptide 1, Liver Cirrhosis, Recurrence, Prognosis, Human Growth Hormone, Growth Hormone, alanine aminotransferase, aspartate aminotransferase, glucagon-like peptide-1, glucagon-like peptide-1 receptor agonist, growth hormone, growth hormone deficiency, liver transplant, metabolic dysfunction-associated steatohepatitis, metabolic dysfunction-associated steatotic liver disease, obesity, panhypopituitarism

Published Open-Access

yes

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