Fatty liver disease found after liver transplant: What next?

Hi, @shameemunnisa, and welcome to Mayo Clinic Connect. I moved your post here and also connected it to the Transplants support group so that you could get support and input from those familiar with your liver transplant and also those who have talked about fatty liver.

What you may have heard is that nonalcoholic fatty liver disease, or NAFLD, can potentially lead to the complication of severe liver scarring, or cirrhosis. This Mayo Clinic article discusses NAFLD in more detail, and the "Complications" section talks more about to what issues cirrhosis can lead:

- Nonalcoholic fatty liver disease https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567

You mentioned the hepatologist did not bother about the fatty liver. However, knowing your particular scan results well, that doctor or your primary care doctor, who likely also has access to those records, may be in the best position to advise about your individual situation. Have you had the chance to ask the hepatologist or your primary care doctor about whether they suggest treating fatty liver and controlling liver enzymes, and if so, what they'd recommend? If you've asked about this, what did they say?

Good morning. I am also about 3.5 years post liver transplant. On my 1 year checkup I was told that I had fatty liver disease. Since my transplant, I had adopted healthier eating habits, so was surprised by the diagnosis. My Mayo team advised me to continue with the healthy eating, but to adopt a regular exercise program - which I have done. I drink mostly water (lots of water) - no soda, or carbonated beverages. At my 2 year post liver checkup, a repeat fiberscan showed that the fatty liver had resolved. So in my case it was possible to correct this. Last thing I wanted was another liver problem. I would push your transplant team for more specific recommendations on how they suggest you proceed.

Best thing you can do: lose a bit of weight if needed (5–10%), eat a Mediterranean-style diet, cut sugar and processed food, and stay active. No alcohol at all. Tacrolimus can mess with blood sugar and fats, so get regular checks. Keep seeing your transplant team, they’ll step in if things get worse.
You're doing well so far.

@shameemunnisa, As a liver/kidney recipient, I would suggest that you make an appointment to speak with someone on your liver transplant team about this. Your health, and the health of your transplanted liver are in your/their top interest.
I am in complete agreement with the helpful guidance from @gerryp and @zanthi. My gastroenterologist, in the very beginning of my liver disease journey stressed: heart healthy eating, physical activity, no alcohol or over-the-counter meds or supplements. (It is interesting for me to note that my PCP said that I could probably have an occasiona; alcholic beverage, but my gastroenterologist said, "No" because with a liver condition, no one knows if/when theliver going to be affected negatively, so why add any stress.) I am now 16 years post liver/kidney transplant and I still get the samre advice: Eat heart healthy, get physical activity, no supplenebts or over-the-counter meds without checking with them first.

Since you are already a liver transplant recipient, You might want to post your question in this group where other liver recipients will be better able to see it.
-Liver transplant - Let's support each other
https://connect.mayoclinic.org/discussion/liver-support-group/
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Have you been able to talk with someone on your transplant team yet?
Do you live near your transplant center? When is your next visit?