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NASH is becoming a leading indication for liver transplants in patients with hepatocellular carcinoma

Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma in the USA, reports this month's issue of Hepatology.

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Nonalcoholic steatohepatitis (NASH) is currently the third leading indication for liver transplantation in the U.S. and is predicted to become the leading indication for liver transplantation in the near future.

The trends in NASH-related hepatocellular carcinoma (HCC) among liver transplantation recipients in the U.S. remain undefined.

Dr Aijaz Ahmed and colleagues from California, USA performed a retrospective cohort study to evaluate trends in the etiology of HCC among adult liver transplantation recipients in the U.S. from 2002 to 2012, using national data from the United Network for Organ Sharing registry.

From 2002-2012, there were 61,868 adults who underwent liver transplantation in the U.S., including 10,061 patients with HCC.

NASH is the second leading etiology of HCC-related liver transplantation
Hepatology

The team noted that the total number and proportion of HCC liver transplant recipients demonstrated a significant increase following the implementation of the Model for Endstage Liver Disease (MELD) scoring system in 2002.

The researchers observed that the proportion of hepatitis C virus (HCV)-related HCC increased steadily from 2002 to 2012, and HCV remained the leading etiology of HCC throughout the MELD era.

The team found that NASH-related HCC also increased significantly, and NASH is the second leading etiology of HCC-related liver transplantation.

From 2002 to 2012, the number of patients undergoing liver transplantation for HCC secondary to NASH increased by nearly 4-fold, and the number of liver transplantation patients with HCC secondary to HCV increased by 2-fold.

Dr Ahmed's team comments, "NASH is the second leading etiology of HCC leading to liver transplantation in the U.S."

"More important, NASH is currently the most rapidly growing indication for liver transplantation in patients with HCC in the U.S."

Hepatology 2014: 59(6): 2188–2195
17 June 2014

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