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Improved survival outcomes in patients with non‐alcoholic steatohepatitis and alcoholic liver disease following liver transplantation: an analysis of 2002–2012 U nited N etwork for O rgan S haring data
Author(s) -
Wong Robert J.,
Chou Christina,
Bonham Clark A.,
Concepcion Waldo,
Esquivel Carlos O.,
Ahmed Aijaz
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12364
Subject(s) - medicine , steatohepatitis , liver transplantation , alcoholic liver disease , gastroenterology , fatty liver , hepatocellular carcinoma , liver disease , alcoholic hepatitis , transplantation , body mass index , model for end stage liver disease , proportional hazards model , hepatitis c , diabetes mellitus , disease , cirrhosis , endocrinology
There is an increasing trend of patients with hepatocellular carcinoma ( HCC ) and non‐alcoholic fatty liver disease undergoing liver transplantation in the US. Our study utilized data from the 2002 to 2012 U nited N etwork for O rgan S haring registry to evaluate model for end‐stage liver disease era trends in US liver transplantations focused on patients with non‐alcoholic steatohepatitis ( NASH ), hepatitis C ( HCV ), alcoholic liver disease ( ALD ), and HCC . Survival outcomes were stratified by liver disease etiology and compared across time periods using K aplan– M eier and Cox proportional hazards models. Patients with NASH were more likely to be women, had higher body mass index ( BMI ), and had higher prevalence of diabetes and cardiac disease. However, overall long‐term survival was significantly higher in patients with NASH and ALD (p < 0.001). Compared to HCV , patients with NASH had significantly higher post‐transplantation survival ( HR 0.69, 95% CI 0.63–0.77), and lower risk of graft failure ( HR 0.76, 95% CI 0.69–0.83). Despite having higher BMI and higher prevalence of diabetes and cardiac disease, patients with NASH had better post‐liver transplantation survival compared to patients with HCV or HCC . Patients with ALD also had superior survival outcomes. However, these survival differences were limited to patients without HCC that underwent liver transplantation.