Nonalcoholic Steatohepatitis Becomes the Leading Indication for Liver Transplant Registrants Among US Adults Born Between 1945 and 1965

Overview

Journal J Clin Exp Hepatol

Publisher Elsevier

Specialty Gastroenterology

Date 2020 Feb 7

PMID 32025164

Citations 11

Authors

Farah Shirazi

Jennifer Wang

Robert J Wong

Affiliations

Soon will be listed here.

Abstract

Background: Improved efforts in screening and treating chronic hepatitis C virus (HCV) infection are expected to reduce its burden among adults on the liver transplantation (LT) waitlist (WL). We aim to evaluate birth cohort-specific liver disease etiology trends in US adults listed for and receiving LT.

Methods: We evaluated 2005-2016 United Network for Organ Sharing LT registry data to evaluate birth cohort-specific trends in LT WL registrants and recipients in the US. Annual trends in etiology of liver disease at listing were compared between the 1945-1965 birth cohort and the non-1945-1965 birth cohort, were stratified by presence of hepatocellular carcinoma (HCC . non-HCC), and were focused on the four leading indications for LT in the US, nonalcoholic steatohepatitis (NASH), HCV infection, alcoholic liver disease (ALD), and those with combined alcoholic cirrhosis with HCV (HCV/ALD).

Results: From 2005 to 2016, although HCV infection was a leading indication for LT WL registration among the 1945-1965 birth cohort patients until 2015, NASH overtook HCV infection as the leading indication in 2016. When stratified by HCC status, both ALD and NASH surpassed HCV infection as the leading indication among 1945-1965 birth cohort WL registrants without HCC, whereas HCV infection remained the leading indication among patients with HCC. When evaluating trends in patients who received LT, HCV infection remained the leading indication among the 1945-1965 birth cohort patients.

Conclusion: In 2016, NASH surpassed HCV infection as the leading indication for WL registration among the 1945-1965 birth cohort patients. Improved HCV screening, increased availability of effective HCV infection treatment, and rising prevalence of nonalcoholic fatty liver disease may explain changes in LT indication among this group.

Citing Articles

Identification of Fast Progressors Among Patients With Nonalcoholic Steatohepatitis Using Machine Learning.

Schattenberg J, Balp M, Reinhart B, Porwal S, Tietz A, Pedrosa M Gastro Hep Adv. 2024; 3(1):101-108.

PMID: 39132186 PMC: 11307632. DOI: 10.1016/j.gastha.2023.09.004.

The plasma degradome reflects later development of NASH fibrosis after liver transplant.

Li J, Sato T, Hernandez-Tejero M, Beier J, Sayed K, Benos P Sci Rep. 2023; 13(1):9965.

PMID: 37340062 PMC: 10282030. DOI: 10.1038/s41598-023-36867-x.

The Non-Invasive Assessment of Circulating D-Loop and mt-ccf Levels Opens an Intriguing Spyhole into Novel Approaches for the Tricky Diagnosis of NASH.

Paolini E, Longo M, Corsini A, Dongiovanni P Int J Mol Sci. 2023; 24(3).

PMID: 36768654 PMC: 9916898. DOI: 10.3390/ijms24032331.

Trends and outcomes of liver transplantation among older recipients in the United States.

Okumura K, Lee J, Dhand A, Sogawa H, Veillette G, John D World J Transplant. 2022; 12(8):259-267.

PMID: 36159074 PMC: 9453296. DOI: 10.5500/wjt.v12.i8.259.

Metabolic mechanisms for and treatment of NAFLD or NASH occurring after liver transplantation.

Lonardo A, Mantovani A, Petta S, Carraro A, Byrne C, Targher G Nat Rev Endocrinol. 2022; 18(10):638-650.

PMID: 35840803 DOI: 10.1038/s41574-022-00711-5.

References

Charlton M, Burns J, Pedersen R, Watt K, Heimbach J, Dierkhising R . Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology. 2011; 141(4):1249-53. DOI: 10.1053/j.gastro.2011.06.061. View

Cholankeril G, Ahmed A . Alcoholic Liver Disease Replaces Hepatitis C Virus Infection as the Leading Indication for Liver Transplantation in the United States. Clin Gastroenterol Hepatol. 2017; 16(8):1356-1358. PMC: 6467713. DOI: 10.1016/j.cgh.2017.11.045. View

Wong R, Cheung R, Ahmed A . Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma in the U.S. Hepatology. 2013; 59(6):2188-95. DOI: 10.1002/hep.26986. View

Chhatwal J, Wang X, Ayer T, Kabiri M, Chung R, Hur C . Hepatitis C Disease Burden in the United States in the era of oral direct-acting antivirals. Hepatology. 2016; 64(5):1442-1450. PMC: 5035714. DOI: 10.1002/hep.28571. View

Liang T, Ghany M . Current and future therapies for hepatitis C virus infection. N Engl J Med. 2013; 368(20):1907-17. PMC: 3893124. DOI: 10.1056/NEJMra1213651. View

Mozumdar A, Liguori G . Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999-2006. Diabetes Care. 2010; 34(1):216-9. PMC: 3005489. DOI: 10.2337/dc10-0879. View

Davis G, Alter M, El-Serag H, Poynard T, Jennings L . Aging of hepatitis C virus (HCV)-infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression. Gastroenterology. 2009; 138(2):513-21, 521.e1-6. DOI: 10.1053/j.gastro.2009.09.067. View

Poordad F, McCone Jr J, Bacon B, Bruno S, Manns M, Sulkowski M . Boceprevir for untreated chronic HCV genotype 1 infection. N Engl J Med. 2011; 364(13):1195-206. PMC: 3766849. DOI: 10.1056/NEJMoa1010494. View

Aguilar M, Bhuket T, Torres S, Liu B, Wong R . Prevalence of the metabolic syndrome in the United States, 2003-2012. JAMA. 2015; 313(19):1973-4. DOI: 10.1001/jama.2015.4260. View

10.

Jacobson I, Gordon S, Kowdley K, Yoshida E, Rodriguez-Torres M, Sulkowski M . Sofosbuvir for hepatitis C genotype 2 or 3 in patients without treatment options. N Engl J Med. 2013; 368(20):1867-77. DOI: 10.1056/NEJMoa1214854. View

11.

Goldberg D, Ditah I, Saeian K, Lalehzari M, Aronsohn A, Gorospe E . Changes in the Prevalence of Hepatitis C Virus Infection, Nonalcoholic Steatohepatitis, and Alcoholic Liver Disease Among Patients With Cirrhosis or Liver Failure on the Waitlist for Liver Transplantation. Gastroenterology. 2017; 152(5):1090-1099.e1. PMC: 5367965. DOI: 10.1053/j.gastro.2017.01.003. View

12.

Pungpapong S, Aqel B, Leise M, Werner K, Murphy J, Henry T . Multicenter experience using simeprevir and sofosbuvir with or without ribavirin to treat hepatitis C genotype 1 after liver transplant. Hepatology. 2015; 61(6):1880-6. DOI: 10.1002/hep.27770. View

13.

Ascha M, Hanouneh I, Lopez R, Tamimi T, Feldstein A, Zein N . The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis. Hepatology. 2010; 51(6):1972-8. DOI: 10.1002/hep.23527. View

14.

Morgan R, Baack B, Smith B, Yartel A, Pitasi M, Falck-Ytter Y . Eradication of hepatitis C virus infection and the development of hepatocellular carcinoma: a meta-analysis of observational studies. Ann Intern Med. 2013; 158(5 Pt 1):329-37. DOI: 10.7326/0003-4819-158-5-201303050-00005. View

15.

Saab S, Park S, Mizokami M, Omata M, Mangia A, Eggleton E . Safety and efficacy of ledipasvir/sofosbuvir for the treatment of genotype 1 hepatitis C in subjects aged 65 years or older. Hepatology. 2015; 63(4):1112-9. DOI: 10.1002/hep.28425. View

16.

Wong R, Aguilar M, Cheung R, Perumpail R, Harrison S, Younossi Z . Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology. 2014; 148(3):547-55. DOI: 10.1053/j.gastro.2014.11.039. View

17.

Tapper E, Parikh N . Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study. BMJ. 2018; 362:k2817. PMC: 6050518. DOI: 10.1136/bmj.k2817. View

18.

Manns M, McHutchison J, Gordon S, Rustgi V, Shiffman M, Reindollar R . Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet. 2001; 358(9286):958-65. DOI: 10.1016/s0140-6736(01)06102-5. View

19.

Kohli A, Shaffer A, Sherman A, Kottilil S . Treatment of hepatitis C: a systematic review. JAMA. 2014; 312(6):631-40. DOI: 10.1001/jama.2014.7085. View

20.

Lawitz E, Sulkowski M, Ghalib R, Rodriguez-Torres M, Younossi Z, Corregidor A . Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders to pegylated interferon and ribavirin and treatment-naive patients: the COSMOS randomised study. Lancet. 2014; 384(9956):1756-65. DOI: 10.1016/S0140-6736(14)61036-9. View