The rising tide of non-alcoholic fatty liver disease (NAFLD) associated with the obesity epidemic is a major international health concern. NAFLD is the leading global cause of liver disease with an estimated prevalence of 25% and is the fastest growing indication for liver transplantation (LT). The presence and severity of liver fibrosis is the only histologic predictor of clinical outcomes in this group. NAFLD poses several challenges in the peri-transplant setting including the management of multiple metabolic co-morbidities, post-transplant obesity and cardiovascular risk. However, post-LT outcomes in well-selected NAFLD patients appear similar to non-NAFLD indications, including in the setting of hepatocellular carcinoma (HCC). The rising prevalence of NAFLD may impact potential liver graft donors, which may in-turn adversely affect post-LT outcomes. This review outlines the current epidemiology, natural history and outcomes of NAFLD with a focus on pre- and post-liver transplant settings.

与肥胖症流行有关的非酒精性脂肪肝疾病（NAFLD）的上升趋势是国际上对健康的主要关注。NAFLD是全球肝病的主要原因，估计患病率达25％，是肝移植（LT）增长最快的适应症。肝纤维化的存在和严重程度是该组临床结局的唯一组织学预测指标。NAFLD在移植周围环境中提出了一些挑战，包括多种代谢性合并症，移植后肥胖和心血管风险的管理。但是，精心挑选的NAFLD患者的LT后结局似乎与非NAFLD适应症相似，包括在肝细胞癌（HCC）的情况下。NAFLD患病率上升可能会影响潜在的肝移植供体，这反过来可能会对LT后的结果产生不利影响。这篇综述概述了NAFLD的当前流行病学，自然病史和预后，重点是肝移植前后的环境。