Original ResearchFull Report: Clinical—LiverNonalcoholic Steatohepatitis Is the Second Leading Etiology of Liver Disease Among Adults Awaiting Liver Transplantation in the United States
Section snippets
Study Population
Adult patients (aged 18 years and older) with chronic liver disease who were registered on the waitlist for liver transplants in the United States from 2004 to 2013 were evaluated using UNOS/OPTN registry data. The etiology of chronic liver disease leading to waitlist registration was determined based on disease diagnosis coding in UNOS/OPTN. Among patients with HCC, the underlying liver disease was determined based on the secondary disease diagnosis codes provided. Patients with both HCV and
Overview
From 2004 to 2013, the overall 4 leading etiologies of chronic liver disease among adult liver transplant waitlist registrants were HCV, ALD, NASH, and HCV/ALD, accounting for 35.2%, 18.3%, 15.8%, and 9.7% of liver transplant waitlist registrants, respectively.
Characteristics of Study Cohort
Compared with patients with NASH, there was a significantly greater proportion of men among patients with HCV (69.8%, n = 21,620), ALD (76.5%, n = 12,338), and HCV/ALD (83.1%, n = 7,111) (Table 1). Waitlist patients with NASH were older
Discussion
Although HCV remains the leading etiology of chronic liver disease among new liver transplant waitlist registrations, NASH demonstrated the greatest increase from 2004 to 2013, and in 2013, NASH became the second leading etiology. Patients with ALD were more likely to survive 90 days on the waitlist compared with NASH patients, but no difference in waitlist mortality was seen among HCV and HCV/ALD patients when compared with NASH patients. Compared with NASH, patients with HCV, ALD, and HCV/ALD
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This article has an accompanying continuing medical education activity on page e14. Learning Objective: Upon completion of this CME exercise, successful learners will be able to explain the impact of the rising prevalence of nonalcoholic steatohepatitis on liver transplant waitlist registrations in the US.
Conflicts of interest The authors disclose no conflicts.