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Gender disparities in liver transplant candidates with nonalcoholic steatohepatitis
Author(s) -
Loy Veronica M.,
Joyce Cara,
Bello Sofia,
VonRoenn Natasha,
Cotler Scott J.
Publication year - 2018
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.13297
Subject(s) - medicine , nonalcoholic steatohepatitis , liver transplantation , cirrhosis , population , steatohepatitis , creatinine , transplantation , fatty liver , nonalcoholic fatty liver disease , environmental health , disease
Background Nonalcoholic steatohepatitis ( NASH ) is the fastest growing indication for liver transplantation ( LT ). Data from the UNOS database were used to compare rates of listing and LT between men and women with NASH . Methods The study population consisted of 76 149 patients listed for LT between 2005 and 2012, 5 492 (7.2%) of who were listed for NASH . Patient characteristics and outcomes were compared by gender. Results Nonalcoholic steatohepatitis was a more frequent indication for transplant listing in women than men throughout the study period. Women had lower serum creatinine levels at listing (1.18 ± 0.76 mg/dL vs 1.28 ± 0.79 mg/dL, P < .001) and were less likely to be listed with exception points (17.7% vs 24.9%, P < .001). Transplantation was less common among women than men with NASH (52.4% vs 64.3%), and women were more likely to experience death on the waiting list (17.1% vs 11.4%) In multivariable analysis adjusting for covariates, the rate of LT remained lower for women with NASH ( aHR 0.81 95% CI : 0.75‐0.88). Conclusions Women with NASH cirrhosis had a higher risk of death on the LT waiting list and were less likely to receive LT compared to men.