Liver Donation if You Have a Family History of Non-alcoholic Fatty Liver Disease (NAFLD)

What is non-alcoholic fatty liver disease (NAFLD)?

Non-alcoholic fatty liver disease (NAFLD) is the build-up of extra fat in your liver cells that is not caused by drinking alcohol. It’s normal for your liver to have some fat. But in NAFLD, more than 5%-10% of your liver’s weight is fat.

NAFLD is common and does not lead to serious liver disease for most people.

Some people with NAFLD can get a more serious type of fatty liver disease called
non-alcoholic steatohepatitis (NASH). In NASH, you have extra fat and liver swelling. NASH can lead to:

  • Cirrhosis (scarring in your liver)
  • Liver cancer
  • Need for a liver transplant

What causes NAFLD?

Doctors don’t know exactly what causes NAFLD. You are more likely to get NAFLD if you:

  • Have a family history of NAFLD
  • Were born a woman
  • Are very overweight or have obesity
  • Have type 2 diabetes
  • Have high blood pressure
  • Have high cholesterol
  • Have parents who are overweight

How will I know if I have NAFLD?

As part of the living liver donor evaluation, your doctor will ask about your family history of NAFLD and liver disease. You will also have tests to measure the amount of fat in your liver, such as:

  • Blood tests
  • Imaging tests, like an MRI

Your center may also do a liver biopsy to know the amount of fat in your liver. In a biopsy, a doctor takes a small sample of liver tissue to look at it in a lab.

Can I donate if I have NAFLD?

If more than 10-15% of your liver’s weight is fat, most centers will not let you donate.

If less than 10-15% of your liver’s weight is fat, most centers will let you donate if you:

  • Are in current good health
  • Meet with a health care professional to understand how to lower your chance of NAFLD becoming a more serious type of fatty liver disease. This may include ways to:
    • Keep a healthy weight
    • Follow a healthy eating plan
    • Be active most days of the week
    • Limit alcohol 



  1. Araújo AR, Rosso N, Bedogni G, Tiribelli C, Bellentani S. Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: What we need in the future. Liver Int. 2018;38 Suppl 1:47-51. doi:10.1111/liv.13643.
  2. Loomba R, Abraham M, Unalp A, et al. Association between diabetes, family history of diabetes, and risk of nonalcoholic steatohepatitis and fibrosis. Hepatology. 2012;56(3):943-951. doi:10.1002/hep.25772.
  3. Abdelmalek MF, Liu C, Shuster J, Nelson DR, Asal NR. Familial aggregation of insulin resistance in first-degree relatives of patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2006;4(9):1162-1169. doi:10.1016/j.cgh.2006.06.001.
  4. Zezos P, Renner EL. Liver transplantation and non-alcoholic fatty liver disease. World J Gastroenterol. 2014;20(42):15532-15538. doi:10.3748/wjg.v20.i42.15532. 

Note: This information is the opinion of the Living Donor Community of Practice (LDCOP) of the American Society of Transplantation. The LDCOP is a group of health care professionals and researchers who specialize in living donation. The LDCOP’s recommendations are meant to offer you helpful information, but you may find opinions from other groups or organizations that are helpful to you, too.

Last Updated: 
June 03, 2022