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There is no agreement on indications for liver biospy which include risk factors for more severe disease such as central obesity (>30 kg/m2), impaired glucose tolerance, diabetes mellitus, hypertension, hyperlipidaemia and transaminase persistently or transfusions more than twice elevated. The author's practice is to avoid transfusions biopsy in these transfusions patients. Back to top Prognosis There is uncertainty about the outlook in NASH because long-term follow-up studies with liver biopsies in large groups of reasonably unselected patients are not (and are unlikely to become) available. Indeed, this is a 'health warning' to be kept in mind in relation to all information about NASH. However, the outlook in general is probably good though there is an increased risk of death from liver disease with about 20% developing cirrhosis and 2-3% progressing to liver failure over 10-20 years.
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