The changing epidemiology of adult liver transplantation in the United States in 2013-2022 : The dominance of metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases..
BACKGROUND: The high prevalence of obesity in the United States drives the burden of NASH, recently renamed as metabolic dysfunction-associated steatohepatitis (MASH). We assessed the most recent trends in liver transplantation in the United States.
METHODS: The Scientific Registry of Transplant Recipients (SRTR 2013-2022) was used to select adult (18 years or above) candidates who underwent liver transplant.
RESULTS: There were 116,292 candidates who underwent liver transplant with known etiology of chronic liver disease. In candidates without HCC, the most common etiology was alcohol-associated liver disease (ALD), increasing from 23% (2013) to 48% (2022), followed by NASH/MASH, which increased from 19% to 27%; the rates of viral hepatitis decreased (chronic hepatitis C: 28%-4%; chronic hepatitis B: 1.8%-1.1%) (all trend p<0.01). The proportion of HCC decreased from 25% (2013-2016) to 17% (2021-2022). Among HCC cohort, the proportion of chronic hepatitis C decreased from 60% (2013) to 27% (2022), NASH/MASH increased from 10% to 31%, alcohol-associated liver disease increased from 9% to 24% (trend p<0.0001), and chronic hepatitis B remained stable between 5% and 7% (trend p=0.62). The rapid increase in the proportion of NASH/MASH in HCC continued during the most recent study years [20% (2018), 28% (2020), 31% (2022)]; the trend remained significant after adjustment for age, sex, ethnicity, obesity, and type 2 diabetes.
CONCLUSIONS: Liver transplant etiologies in the United States have changed over the last decade. Alcohol-associated liver disease and NASH/MASH remain the 2 most common indications for transplantation among those without HCC, and NASH/MASH is the most common in patients with HCC.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 2023 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
Hepatology communications - 8(2023), 1 vom: 01. Jan. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Younossi, Zobair M [VerfasserIn] |
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Date Completed 22.12.2023 Date Revised 27.12.2023 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.1097/HC9.0000000000000352 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM366175939 |
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| 100 | 1 | |a Younossi, Zobair M |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The changing epidemiology of adult liver transplantation in the United States in 2013-2022 |b The dominance of metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease |
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| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases. | ||
| 520 | |a BACKGROUND: The high prevalence of obesity in the United States drives the burden of NASH, recently renamed as metabolic dysfunction-associated steatohepatitis (MASH). We assessed the most recent trends in liver transplantation in the United States | ||
| 520 | |a METHODS: The Scientific Registry of Transplant Recipients (SRTR 2013-2022) was used to select adult (18 years or above) candidates who underwent liver transplant | ||
| 520 | |a RESULTS: There were 116,292 candidates who underwent liver transplant with known etiology of chronic liver disease. In candidates without HCC, the most common etiology was alcohol-associated liver disease (ALD), increasing from 23% (2013) to 48% (2022), followed by NASH/MASH, which increased from 19% to 27%; the rates of viral hepatitis decreased (chronic hepatitis C: 28%-4%; chronic hepatitis B: 1.8%-1.1%) (all trend p<0.01). The proportion of HCC decreased from 25% (2013-2016) to 17% (2021-2022). Among HCC cohort, the proportion of chronic hepatitis C decreased from 60% (2013) to 27% (2022), NASH/MASH increased from 10% to 31%, alcohol-associated liver disease increased from 9% to 24% (trend p<0.0001), and chronic hepatitis B remained stable between 5% and 7% (trend p=0.62). The rapid increase in the proportion of NASH/MASH in HCC continued during the most recent study years [20% (2018), 28% (2020), 31% (2022)]; the trend remained significant after adjustment for age, sex, ethnicity, obesity, and type 2 diabetes | ||
| 520 | |a CONCLUSIONS: Liver transplant etiologies in the United States have changed over the last decade. Alcohol-associated liver disease and NASH/MASH remain the 2 most common indications for transplantation among those without HCC, and NASH/MASH is the most common in patients with HCC | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Stepanova, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Al Shabeeb, Reem |e verfasserin |4 aut | |
| 700 | 1 | |a Eberly, Katherine E |e verfasserin |4 aut | |
| 700 | 1 | |a Shah, Dipam |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Veronica |e verfasserin |4 aut | |
| 700 | 1 | |a Ong, Janus |e verfasserin |4 aut | |
| 700 | 1 | |a Henry, Linda |e verfasserin |4 aut | |
| 700 | 1 | |a Alqahtani, Saleh A |e verfasserin |4 aut | |
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