Temporal Trends Associated With the Rise in Alcoholic Liver Disease-related Liver Transplantation in the United States
Temporal Trends Associated With the Rise in Alcoholic Liver Disease-related Liver Transplantation in the United States
复制标题
DOI：
10.1097/tp.0000000000002471
复制
发表时间：
2019-01-01
期刊：
影响因子：
6.2
通讯作者：
Ahmed, Aijaz
中科院分区：
文献类型：
--
作者：
Cholankeril, George;Gadiparthi, Chiranjeevi;Ahmed, Aijaz
背景在美国，酒精性肝病（ALD）最近已成为肝移植的主要指征。方法.使用器官共享联合网络登记处，我们检查了2007年至2016年因ALD而患有慢性肝病（CLD）的成人肝移植等待名单（WL）登记者和接受者的时间趋势。结果从2007年到2016年，ALD占所有CLD WL增加的20.4%（18399）。2007年，年龄标准化ALD WL添加率为每10万美国人口0.459人; 2016年几乎翻了一番，达到每10万美国人口0.872人，平均年百分比变化为47.56%（95%置信区间，30.33%至64.72%）。在研究期间，年轻人（18-39岁）和中年人（40-59岁）的ALD WL添加率增加了两倍以上。与中年和老年人（> 60岁）相比，年轻成人ALD WL增加表现出更高的肝病严重程度，包括终末期肝病模型评分。从2014年到2016年，年度ALD WL死亡人数迅速上升，尽管所有CLD WL死亡人数总体上每年都在下降。严重肝性脑病、低体重指数（
Background. In the United States, alcoholic liver disease (ALD) has recently become the leading indication for liver transplantation. Methods. Using the United Network for Organ Sharing registry, we examined temporal trends in adult liver transplant waitlist (WL) registrants and recipients with chronic liver disease (CLD) due to ALD from 2007 to 2016. Results. From 2007 to 2016, ALD accounted for 20.4% (18399) of all CLD WL additions. The age-standardized ALD WL addition rate was 0.459 per 100000 US population in 2007; nearly doubled to 0.872 per 100000 US population in 2016 and increased with an average annual percent change of 47.56% (95% confidence interval, 30.33% to 64.72%). The ALD WL addition rate increased over twofold among young (18-39 years) and middle-aged (40-59 years) adults during the study period. Young adult ALD WL additions presented with a higher severity of liver disease including Model for End-Stage Liver Disease score compared to middle aged and older adults (> 60 years). The number of annual ALD WL deaths readily rose from 2014 to 2016, despite an overall annual decline in all CLD WL deaths. Severe hepatic encephalopathy, low body mass index (