Frequency and Outcomes of Liver Transplantation for Nonalcoholic Steatohepatitis in the United States
Frequency and Outcomes of Liver Transplantation for Nonalcoholic Steatohepatitis in the United States
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DOI：
10.1053/j.gastro.2011.06.061
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发表时间：
2011-10-01
期刊：
影响因子：
29.4
通讯作者：
Dierkhising, Ross A.
中科院分区：
文献类型：
--
作者：
Charlton, Michael R.;Burns, Justin M.;Dierkhising, Ross A.
背景与目的：非酒精性脂肪性肝炎（NASH）作为肝移植指征的相对频率和移植后的比较结果尚不清楚。方法：我们分析2001年至2009年成人原发性肝移植受者的科学登记。结果：从2001年到2009年，35,781例患者接受了原发性肝移植，包括1959例NASH为主要或次要指征的患者。接受肝移植的NASH患者比例从2001年的1.2%上升到2009年的9.7%。NASH目前是美国第三大常见肝移植适应症。在研究期间，肝移植的其他适应症的频率没有增加。与其他肝移植指征相比，NASH受者年龄较大（58.5 +/- 8.0岁vs 53.0 +/- 8.9岁，P < 0.001），体重指数较大（bb0 30 kg/m(2)） （63% vs 32%, P < 0.001），女性较多（47% vs 29%, P < 0.001），肝细胞癌发生率较低（12% vs 19%, P < 0.001）。肝移植后1年和3年的生存率分别为84%和78%，而其他适应症的生存率分别为87%和78% （P = 0.67）。在调整肌酐水平、性别、年龄和体重指数后，NASH肝受者的患者和移植物存活率与其他适应症相似。结论：NASH是美国第三大最常见的肝移植适应症，并且正在成为最常见的适应症。NASH患者接受肝移植的结果与其他适应症相似。
BACKGROUND & AIMS: The relative frequency of nonalcoholic steatohepatitis (NASH) as an indication for liver transplantation and comparative outcomes following transplantation are poorly understood. METHODS: We analyzed the Scientific Registry of Transplant Recipients for primary adult liver transplant recipients from 2001 to 2009. RESULTS: From 2001 to 2009, 35,781 patients underwent a primary liver transplant, including 1959 for who NASH was the primary or secondary indication. The percentage of patients undergoing a liver transplant for NASH increased from 1.2% in 2001 to 9.7% in 2009. NASH is now the third most common indication for liver transplantation in the United States. No other indication for liver transplantation increased in frequency during the study period. Compared with other indications for liver transplantation, recipients with NASH are older (58.5 +/- 8.0 vs 53.0 +/- 8.9 years; P < .001), have a larger body mass index (>30 kg/m(2)) (63% vs 32%; P < .001), are more likely to be female (47% vs 29%; P < .001), and have a lower frequency of hepatocellular carcinoma (12% vs 19%; P < .001). Survival at 1 and 3 years after liver transplantation for NASH was 84% and 78%, respectively, compared with 87% and 78% for other indications (P = .67). Patient and graft survival for liver recipients with NASH were similar to values for other indications after adjusting for level of creatinine, sex, age, and body mass index. CONCLUSIONS: NASH is the third most common indication for liver transplantation in the United States and is on a trajectory to become the most common. Outcomes for patients undergoing a liver transplant for NASH are similar to those for other indications.