NASH is caused by fat accumulating in the liver, damaging tissue. There are multiple stages of NASH. If it progresses, the end/worst stage is cirrhosis, which is scarring of the liver. If it continues to progress, it leads to liver failure. The good news is that the liver has the potential to repair itself prior to cirrhosis. I'm a relatively new liver transplant recipient. I did not have NASH, as my cirrhosis was caused by alcohol. But in my case as well as yours, the physiological culprit is fat in the liver. I've learned quite a bit about liver health over the past few years, as I'm extremely interested in keeping my new liver in good shape. If you're interested in what you can do slow, stop or reverse the progression of your disease, I'd be more than happy to share my opinions.