Alcohol-related liver disease has surpassed HCV infection as the most common indication for liver transplantation. With the advent of direct-acting antiviral therapies for hepatitis C virus (HCV) infection, the frequency of liver transplantation (LT) performed because of HCV infection is expected to decline. A recent study did show this down-trending of HCV as an indication for LT through 2015, though it was still the leading indication for LT. Researchers have now updated those data from the United Network for Organ Sharing, analyzing the proportions of annual waitlist additions and LT surgeries attributed to the three leading causes of LT — HCV, alcoholic liver disease (ALD), and nonalcoholic steatohepatitis (NASH) — through December 2016. A subanalysis of limited data from January 2017 through October 2017 was also performed. From 2012 to 2016, chronic liver disease increased among LT waitlist additions by 2% and among LT surgeries by 8%. During 2016, ALD became the leading indication for waitlist additions (30%) and together with NASH (21%) accounted for over half of waitlist additions. The two diseases also overtook HCV to become the first (ALD) and second (NASH) leading causes of LT surgery. These trends are continuing in 2017, during which the annual number of LT surgeries is likely to reach a record high. |
|
|
Leave a Reply Cancel reply
You must be logged in to post a comment.
COMMENT
Alcohol-related liver disease has now surpassed HCV as the most common indication for LT in the U.S. As national efforts to identify and treat more patients with HCV infection continue, it will continue to decrease as an indication for LT, while NASH and alcoholic-related liver disease will continue to rise. Unfortunately, I suspect that if we do not make a concerted effort to address the fatty liver disease epidemic, the LT rate in the U.S. may not decrease.