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Nonalcoholic fatty liver disease is an increasing indication for liver transplantation in the Nordic countries
Author(s) -
Holmer Magnus,
Melum Espen,
Isoniemi Helena,
Ericzon BoGöran,
Castedal Maria,
Nordin Arno,
Aagaard Schultz Nicolai,
Rasmussen Allan,
Line PålDag,
Stål Per,
Bennet William,
Hagström Hannes
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13751
Subject(s) - liver transplantation , medicine , nonalcoholic fatty liver disease , transplantation , liver disease , gastroenterology , model for end stage liver disease , body mass index , cirrhosis , fatty liver , population , disease , environmental health
Background & Aims Nonalcoholic fatty liver disease(NAFLD) is the second most common cause of liver transplantation in the US . Data on NAFLD as a liver transplantation indication from countries with lower prevalences of obesity are lacking. We studied the temporal trends of NAFLD as an indication for liver transplantation in the Nordic countries, and compared outcomes for patients with NAFLD to patients with other indications for liver transplantation. Method Population‐based cohort study using data from the Nordic Liver Transplant Registry on adults listed for liver transplantation between 1994 and 2015. NAFLD as the underlying indication for liver transplantation was defined as a listing diagnosis of NAFLD/nonalcoholic steatohepatitis, or cryptogenic cirrhosis with a body mass index ≥25 kg/m 2 and absence of other liver diseases. Waiting time for liver transplantation, mortality and withdrawal from the transplant waiting list were registered. Survival after liver transplantation was calculated using multivariable Cox regression, adjusted for age, sex, body mass index and model for end‐stage liver disease. Results A total of 4609 patients listed for liver transplantation were included. NAFLD as the underlying indication for liver transplantation increased from 2.0% in 1994‐1995 to 6.2% in 2011‐2015 ( P = .01) and was the second most rapidly increasing indication. NAFLD patients had higher age, model for end‐stage liver disease and body mass index when listed for liver transplantation, but overall survival after liver transplantation was comparable to non‐‐NAFLD patients ( aHR 1.03, 95% CI 0.70‐1.53 P = .87). Conclusion NAFLD is an increasing indication for liver transplantation in the Nordic countries. Despite more advanced liver disease, NAFLD patients have a comparable survival to other patients listed for liver transplantation.