George Cholankeril1, Chiranjeevi Gadiparthi2, Eric R Yoo3, Brittany B Dennis4, Andrew A Li5, Menghan Hu6, Katherine Wong1, Donghee Kim1, Aijaz Ahmed1. 1. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA. 2. Division of Gastroenterology and Hepatology, Saint Peter's University Hospital, New Brunswick, NJ. 3. Department of Internal Medicine, Santa Clara Valley Medical Center, Santa Clara, CA. 4. Department of Medicine, Saint Georges Hospital, University of London, London, United Kingdom. 5. Department of Medicine, Stanford University School of Medicine, Stanford, CA. 6. Department of Biostatistics, Brown University, Providence, RI.
Abstract
BACKGROUND: In the United States, alcoholic liver disease (ALD) has recently become the leading indication for liver transplantation. METHODS: Using the United Network for Organ Sharing registry, we examined temporal trends in adult liver transplant waitlist (WL) registrants and recipients with chronic liver disease (CLD) due to ALD from 2007 to 2016. RESULTS: From 2007 to 2016, ALD accounted for 20.4% (18 399) of all CLD WL additions. The age-standardized ALD WL addition rate was 0.459 per 100 000 US population in 2007; nearly doubled to 0.872 per 100 000 US population in 2016 and increased with an average annual percent change of 47.56% (95% confidence interval, 30.33% to 64.72%).The ALD WL addition rate increased over twofold among young (18-39 years) and middle-aged (40-59 years) adults during the study period. Young adult ALD WL additions presented with a higher severity of liver disease including Model for End-Stage Liver Disease score compared to middle aged and older adults (≥60 years). The number of annual ALD WL deaths readily rose from 2014 to 2016, despite an overall annual decline in all CLD WL deaths. Severe hepatic encephalopathy, low body mass index (<18.5) and diabetes mellitus were significant predictors for 1-year WL mortality. CONCLUSIONS: Alcoholic liver disease-related WL registrations and liver transplantation have increased over the past decade with a disproportionate increase in young and middle-aged adults. These subpopulations within the ALD cohort need to be evaluated in future studies to improve our understanding of factors associated with these alarming trends.
BACKGROUND: In the United States, alcoholic liver disease (ALD) has recently become the leading indication for liver transplantation. METHODS: Using the United Network for Organ Sharing registry, we examined temporal trends in adult liver transplant waitlist (WL) registrants and recipients with chronic liver disease (CLD) due to ALD from 2007 to 2016. RESULTS: From 2007 to 2016, ALD accounted for 20.4% (18 399) of all CLD WL additions. The age-standardized ALD WL addition rate was 0.459 per 100 000 US population in 2007; nearly doubled to 0.872 per 100 000 US population in 2016 and increased with an average annual percent change of 47.56% (95% confidence interval, 30.33% to 64.72%).The ALD WL addition rate increased over twofold among young (18-39 years) and middle-aged (40-59 years) adults during the study period. Young adult ALD WL additions presented with a higher severity of liver disease including Model for End-Stage Liver Disease score compared to middle aged and older adults (≥60 years). The number of annual ALD WL deaths readily rose from 2014 to 2016, despite an overall annual decline in all CLD WL deaths. Severe hepatic encephalopathy, low body mass index (<18.5) and diabetes mellitus were significant predictors for 1-year WL mortality. CONCLUSIONS:Alcoholic liver disease-related WL registrations and liver transplantation have increased over the past decade with a disproportionate increase in young and middle-aged adults. These subpopulations within the ALD cohort need to be evaluated in future studies to improve our understanding of factors associated with these alarming trends.
Authors: Dipankar Bhattacharya; Christine Becker; Benjamin Readhead; Nicolas Goossens; Jacqueline Novik; Maria Isabel Fiel; Leslie P Cousens; Björn Magnusson; Anna Backmark; Ryan Hicks; Joel T Dudley; Scott L Friedman Journal: Sci Rep Date: 2021-10-21 Impact factor: 4.379
Authors: George Cholankeril; Karthik Goli; Abbas Rana; Ruben Hernaez; Alexander Podboy; Prasun Jalal; Ben L Da; Sanjaya K Satapathy; Donghee Kim; Aijaz Ahmed; John Goss; Fasiha Kanwal Journal: Hepatology Date: 2021-09-28 Impact factor: 17.298