Fundamentals of Liver Disease - MASLD (2026)-MASH and MASLD

Video Transcription

Video Summary

The lecture reviewed management of MASH cirrhosis in liver transplant assessment. Key points: obesity and metabolic comorbidities such as diabetes, hypertension, CKD, and sleep apnea are common and worsen portal hypertension, decompensation risk, and transplant complexity. Weight loss and exercise can safely reduce hepatic venous pressure gradient, while sarcopenia is an important but often underrecognized predictor of poor waitlist and post-transplant outcomes. Standard cirrhosis care remains similar, but clinicians should continue statins, consider nonselective beta blockers, and be cautious with ACE inhibitors/ARBs in hypotension or renal dysfunction. MASH and MET-ALD increase hepatocellular carcinoma risk, requiring ongoing surveillance. Transplant evaluation must emphasize cardiovascular screening and nutrition assessment. After transplant, metabolic disease often persists or worsens, making long-term management of diabetes, lipids, kidney function, and cardiovascular risk essential.

Keywords

MASH cirrhosis

liver transplant assessment

metabolic comorbidities

sarcopenia

hepatocellular carcinoma surveillance

post-transplant management