Iliana Doycheva1, Danny Issa2, Kymberly D Watt3, Rocio Lopez4, Ghassoub Rifai5, Naim Alkhouri6. 1. Division of Gastroenterology and Hepatology, Medical University, Sofia, Bulgaria. 2. Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA. 3. Gastroenterology and Hepatology Department, Mayo Clinic, Rochester, MN. 4. Department of Quantitative Health Sciences, Lerner Research Institute. 5. Digestive Disease Institute, Cleveland Clinic, Cleveland, OH. 6. Texas Liver Institute, San Antonio, TX.
Abstract
GOALS: To analyze the frequency and trend of liver transplantation (LT) for nonalcoholic steatohepatitis (NASH) cirrhosis in young adults aged 18 to 40 years and to assess post-LT outcomes in this age group. BACKGROUND: NASH is currently the fastest-growing indication for LT in US adults. It is believed that NASH is a rare indication for LT among young adults. STUDY: Using the United Network for Organ Sharing database, we performed a retrospective cohort analysis of all LTs in young adults between 2002 and 2012. Incidence rate ratio was calculated for each indication. RESULTS: A total of 5157 young adults underwent LT over the study period-54% were male, 23% obese. Mean (±SD) age and body mass index were 31.6±6.7 years and 26.3±6.1 kg/m, respectively. The incidence of LTs performed for NASH cirrhosis increased from 0.53% in 2002 to 4.46% in 2012. NASH was the most rapidly growing indication for LT among all other etiologies with a 14% increment per year (incidence rate ratio, 1.14; 95% confidence interval, 1.09-1.20, P<0.001). The 5-year post-LT outcomes were comparable between NASH and non-NASH recipients, but graft survival was lower and retransplantation cumulative rates were higher in NASH recipients compared with those with other metabolic liver diseases (63.5% vs. 81.4%, P=0.003 and 12.7% vs. 4.2%, P=0.046, respectively). CONCLUSIONS: NASH is the fastest-growing indication for LT among young US adults aged 18 to 40 years and now accounts for almost 5% of all LTs in this age group.
GOALS: To analyze the frequency and trend of liver transplantation (LT) for nonalcoholic steatohepatitis (NASH) cirrhosis in young adults aged 18 to 40 years and to assess post-LT outcomes in this age group. BACKGROUND: NASH is currently the fastest-growing indication for LT in US adults. It is believed that NASH is a rare indication for LT among young adults. STUDY: Using the United Network for Organ Sharing database, we performed a retrospective cohort analysis of all LTs in young adults between 2002 and 2012. Incidence rate ratio was calculated for each indication. RESULTS: A total of 5157 young adults underwent LT over the study period-54% were male, 23% obese. Mean (±SD) age and body mass index were 31.6±6.7 years and 26.3±6.1 kg/m, respectively. The incidence of LTs performed for NASH cirrhosis increased from 0.53% in 2002 to 4.46% in 2012. NASH was the most rapidly growing indication for LT among all other etiologies with a 14% increment per year (incidence rate ratio, 1.14; 95% confidence interval, 1.09-1.20, P<0.001). The 5-year post-LT outcomes were comparable between NASH and non-NASH recipients, but graft survival was lower and retransplantation cumulative rates were higher in NASH recipients compared with those with other metabolic liver diseases (63.5% vs. 81.4%, P=0.003 and 12.7% vs. 4.2%, P=0.046, respectively). CONCLUSIONS: NASH is the fastest-growing indication for LT among young US adults aged 18 to 40 years and now accounts for almost 5% of all LTs in this age group.
Authors: Edoardo G Giannini; Claudia Coppo; Chiara Romana; Giovanni B Camerini; Franco De Cian; Nicola Scopinaro; Francesco S Papadia Journal: Dig Dis Sci Date: 2018-04-09 Impact factor: 3.199
Authors: Ali Zarrinpar; Claire M Faltermeier; Vatche G Agopian; Bita V Naini; Michael P Harlander-Locke; Fady M Kaldas; Douglas G Farmer; Ronald W Busuttil Journal: Liver Int Date: 2018-12-02 Impact factor: 5.828
Authors: Elizabeth L Yu; Shahrokh Golshan; Kathryn E Harlow; Jorge E Angeles; Janis Durelle; Nidhi P Goyal; Kimberly P Newton; Mary Catherine Sawh; Jonathan Hooker; Ethan Z Sy; Michael S Middleton; Claude B Sirlin; Jeffrey B Schwimmer Journal: J Pediatr Date: 2018-12-14 Impact factor: 4.406
Authors: Nidhi P Goyal; Mary Catherine Sawh; Patricia Ugalde-Nicalo; Jorge E Angeles; James A Proudfoot; Kimberly P Newton; Michael S Middleton; Claude B Sirlin; Jeffrey B Schwimmer Journal: J Pediatr Gastroenterol Nutr Date: 2020-01 Impact factor: 2.839
Authors: Stephanie J Wu; Jeanne A Darbinian; Jeffrey B Schwimmer; Elizabeth L Yu; Nirmala D Ramalingam; Louise C Greenspan; Joan C Lo Journal: J Pediatr Date: 2021-09-23 Impact factor: 4.406
Authors: Bishuang Cai; Paola Dongiovanni; Kathleen E Corey; Xiaobo Wang; Igor O Shmarakov; Ze Zheng; Canan Kasikara; Viralkumar Davra; Marica Meroni; Raymond T Chung; Carla V Rothlin; Robert F Schwabe; William S Blaner; Raymond B Birge; Luca Valenti; Ira Tabas Journal: Cell Metab Date: 2019-12-12 Impact factor: 27.287