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Outcomes of liver t...
Outcomes of liver transplantation in non-alcoholic steatohepatitis (NASH) versus non-NASH associated hepatocellular carcinoma
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- Rajendran, Luckshi (författare)
- Univ Toronto, Dept Surg, Div Gen Surg, Toronto, ON, Canada.
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- Perez, Carla F. Murillo (författare)
- Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Toronto Ctr Liver Dis, Toronto, ON, Canada.;Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada.
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- Ivanics, Tommy (författare)
- Uppsala universitet,Gastrointestinalkirurgi,Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI USA.
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- Claasen, Marco P. A. W. (författare)
- Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Med Ctr Rotterdam, Erasmus MC Transplant Inst, Dept Surg, Div HPB & Transplant Surg, Rotterdam, Netherlands.
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- Hansen, Bettina E. (författare)
- Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Toronto Ctr Liver Dis, Toronto, ON, Canada.;Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada.
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- Wallace, David (författare)
- London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.;Kings Coll Hosp London, Inst Liver Studies, Denmark Hill, London, England.
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- Yoon, Peter D. (författare)
- Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Westmead Hosp, Dept Surg, Sydney, Australia.
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- Sapisochin, Gonzalo (författare)
- Univ Toronto, Dept Surg, Div Gen Surg, Toronto, ON, Canada.;Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Toronto, Univ Hlth Network, Staff Surg HBP & MultiOrgan Transplant Program, Div Gen Surg, 585 Univ Ave,11PMB184, Toronto, ON M5G 2N2, Canada.
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Univ Toronto, Dept Surg, Div Gen Surg, Toronto, ON, Canada Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Toronto Ctr Liver Dis, Toronto, ON, Canada.;Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada. (creator_code:org_t)
- Elsevier BV, 2023
- 2023
- Engelska.
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Ingår i: HPB. - : Elsevier BV. - 1365-182X .- 1477-2574. ; 25:5, s. 556-567
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Non-alcoholic steatohepatitis (NASH)-associated hepatocellular carcinoma (HCC) is a rising indication for liver transplantation. This unique population, with multiple comorbidities, has po-tential for worse post-transplant outcomes. We compared post-transplant survival of NASH and non-NASH HCC patients using a large cohort.Methods: Adults transplanted for HCC between 2008 and 2018, from United Network for Organ Sharing (UNOS) and University Health Network (UHN) databases were divided into two populations: NASH and non-NASH. Recipient characteristics and post-transplant survival were compared. Subgroup analyses were performed within and beyond Milan criteria.Results: 2071 of 20,672 (10.0%) patients underwent transplantation for NASH HCC, with annual pro-portional increase of 1.2%UHN (p = 0.02) and 1.3%UNOS (p < 0.001). The 1-,3-,5-year post-transplant survival were 90.8%, 83.9%, 76.3% NASH HCC versus 91.9%, 82.1%, 74.9% non-NASH HCC (p = 0.94). No survival differences were observed in populations within or beyond Milan. Competing-risk analysis demonstrated no differences in risk for cardiovascular-related death (HR1.24, 95%CI 0.87-1.55, p = 0.16), or HCC recurrence-related death (HR1.21, 95%CI 0.89-1.65, p = 0.23). NASH HCC patients had lower risk of liver-related deaths (HR0.57, 95%CI 0.34-0.98, p = 0.04).Discussion: NASH HCC is a rising indication for liver transplantation. Despite demographic differences, no post-transplantation survival differences were observed between NASH and non-NASH HCC. This justifies equivalent organ allocation, irrespective of NASH status.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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