PMID- 37752016
OWN - NLM
STAT- MEDLINE
DCOM- 20231127
LR  - 20231207
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Print)
IS  - 0041-1345 (Linking)
VI  - 55
IP  - 9
DP  - 2023 Nov
TI  - Liver Transplant Outcomes in Young Adults with Cirrhosis Related to Nonalcoholic 
      Fatty Liver Disease.
PG  - 2134-2142
LID - S0041-1345(23)00561-4 [pii]
LID - 10.1016/j.transproceed.2023.08.020 [doi]
AB  - BACKGROUND: The prevalence of nonalcoholic fatty liver disease (NASH) and 
      cryptogenic cirrhosis (CC) is constantly increasing in adolescents and young 
      adults (AYAs). METHODS: In a retrospective UNOS database evaluation, we analyzed 
      postoperative outcomes of AYAs with nonalcoholic NASH/CC undergoing LT between 
      January 1(st), 2003 and March 5(th), 2021. After exclusions, 85,970 LT 
      recipients, 393 (47.1%) AYAs with NASH/CC and 441 (52.9%) AYAs with other 
      metabolic conditions, were analyzed. RESULTS: During the study period, the number 
      of LTs performed for AYAs with NASH/CC increased from 4%-7% but decreased from 
      6.6%-5.3% compared to LTs performed for NASH/CC in all ages. In comparison to 
      AYAs with other metabolic conditions, AYA LT recipients with NASH/CC had a higher 
      prevalence of metabolic syndrome (MetS) components, including diabetes and 
      increased body mass index (P < .0001 for both). Patient and graft survival in 
      AYAs with NASH/CC were significantly lower in comparison to AYAs transplanted for 
      other metabolic conditions (P < .0001) (Hazard Ratio = 1.93, P < .001). Patient 
      survival in AYAs with NASH/CC was significantly better in comparison to older 
      (40-65-year-old) patients with the same diagnosis (P = .01). CONCLUSIONS: Our 
      study found that the overall number of LTs in AYAs with NASH increased 
      significantly, but to a lesser degree compared to the older population with the 
      same diagnosis. Outcomes after LT in AYAs with NASH/CC were worse compared to LT 
      for other metabolic conditions, but significantly better in comparison to older 
      patients. The prevalence of LT for NASH/CC in AYAs is growing. MetS may 
      contribute to worse outcomes in AYAs.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Bezinover, Dmitri
AU  - Bezinover D
AD  - Department of Anesthesiology and Critical Care, Perelman School of Medicine, 
      University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: 
      Dmitri.Bezinover@Pennmedicine.upenn.edu.
FAU - Alhkouri, Naim
AU  - Alhkouri N
AD  - Department of Hepatology, Arizona Liver Health, Chandler, Arizona.
FAU - Schumann, Roman
AU  - Schumann R
AD  - Department of Anesthesiology, Critical Care and Pain Medicine, VA Boston 
      Healthcare System, West Roxbury, Massachusetts.
FAU - Geyer, Nathaniel
AU  - Geyer N
AD  - The Pennsylvania State University, Department of Public Health Sciences, Hershey, 
      Pennsylvania.
FAU - Chinchilli, Vernon
AU  - Chinchilli V
AD  - The Pennsylvania State University, Department of Public Health Sciences, Hershey, 
      Pennsylvania.
FAU - Stine, Jonathan G
AU  - Stine JG
AD  - The Pennsylvania State University, Department of Public Health Sciences, Hershey, 
      Pennsylvania; The Pennsylvania State University, Hershey Medical Center, Division 
      of Gastroenterology and Hepatology, Department of Medicine, Hershey, 
      Pennsylvania.
LA  - eng
GR  - K23 DK131290/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20230924
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - Cirrhosis, Cryptogenic
SB  - IM
MH  - Adolescent
MH  - Humans
MH  - Young Adult
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - *Non-alcoholic Fatty Liver Disease/complications/surgery/diagnosis
MH  - *Liver Transplantation/adverse effects
MH  - Retrospective Studies
MH  - Liver Cirrhosis/surgery/diagnosis
MH  - *Metabolic Syndrome/complications/epidemiology
MH  - Risk Factors
PMC - PMC10699163
MID - NIHMS1946892
COIS- Declaration of Competing Interest This research was supported by a grant from the 
      Department of Anesthesiology and Perioperative Medicine, Penn State Hershey 
      Medical Center. Research reported in this publication was supported by the 
      National Institute of Diabetes and Digestive and Kidney Diseases of the National 
      Institutes of Health under Award Number K23DK131290 (Dr Sine). This grant was not 
      used for the financial support of this study but has to be mentioned by all 
      publication related to this author.
EDAT- 2023/09/27 00:42
MHDA- 2023/11/27 12:42
PMCR- 2023/12/06
CRDT- 2023/09/26 21:51
PHST- 2023/04/09 00:00 [received]
PHST- 2023/07/07 00:00 [revised]
PHST- 2023/08/01 00:00 [accepted]
PHST- 2023/11/27 12:42 [medline]
PHST- 2023/09/27 00:42 [pubmed]
PHST- 2023/09/26 21:51 [entrez]
PHST- 2023/12/06 00:00 [pmc-release]
AID - S0041-1345(23)00561-4 [pii]
AID - 10.1016/j.transproceed.2023.08.020 [doi]
PST - ppublish
SO  - Transplant Proc. 2023 Nov;55(9):2134-2142. doi: 
      10.1016/j.transproceed.2023.08.020. Epub 2023 Sep 24.