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Excellent posttransplant survival for patients with nonalcoholic steatohepatitis in the United States

Authors

  • Anita Afzali,

    Corresponding author
    1. Department of Medicine, Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, WA, University of Washington, Seattle, WA
    2. Research Enhancement Award Program, Veterans Affairs Puget Sound Health Care System, Seattle, WA
    • Division of Gastroenterology, Department of Medicine, University of Washington, 1959 Northeast Pacific Street, Suite AA103, Box 356424, Seattle, WA 98195-6424
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    • Telephone: 206-685-3195; FAX: 206-685-8684

  • Kristin Berry,

    1. Department of Biostatistics, University of Washington, Seattle, WA
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  • George N. Ioannou

    1. Department of Medicine, Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, WA, University of Washington, Seattle, WA
    2. Research Enhancement Award Program, Veterans Affairs Puget Sound Health Care System, Seattle, WA
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  • Anita Afzali M.D., M.P.H., contributed to the study concept and design, the acquisition of data, the statistical analysis and interpretation of data, the drafting of the manuscript, and a critical revision of the manuscript for important intellectual content. Kristin Berry P.H.D., contributed to the study concept and design, the acquisition of data, and the statistical analysis and interpretation of data. George N. Ioannou M.D., M.S., contributed to the study concept and design, the analysis and interpretation of data, and a critical revision of the manuscript for important intellectual content.

  • This work was supported in part by the Health Resources and Services Administration (contract 234-2005-370011C). The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.

Abstract

Because of the ongoing epidemics of obesity and diabetes, nonalcoholic steatohepatitis (NASH) may become a leading indication for liver transplantation. There are concerns about the posttransplant survival of patients with NASH because of associated cardiovascular and metabolic risk factors. We aimed to determine recent trends in the proportion of patients undergoing transplantation for NASH-related cirrhosis in the United States and to estimate their posttransplant survival. We used data provided by the United Network for Organ Sharing for first-time adult cadaveric liver transplants performed in the United States between January 1, 1997 and October 31, 2010 (n = 53,738). The proportion of liver transplants performed for NASH-related cirrhosis increased dramatically from 1.2% in 1997-2003 to 7.4% in 2010 when NASH was the fourth most common indication for transplantation. The posttransplant survival of patients with NASH (n = 1810) at 1 (87.6%), 3 (82.2%), and 5 years (76.7%) was superior to the survival of patients with hepatocellular carcinoma, hepatitis C virus, alcoholic liver disease, acute hepatic necrosis, hemochromatosis, or cryptogenic liver disease and was inferior to the survival of only 4 groups of patients (those with primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis, or hepatitis B virus). In conclusion, NASH-related cirrhosis is increasing rapidly as an indication for liver transplantation in the United States and is associated with excellent posttransplant survival. Liver Transpl 18:29–37, 2012. © 2011 AASLD.

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