Surging Liver Transplantation for Nonalcoholic Steatohepatitis from 2000-2022: A National Database Study

Area of Science:

• Hepatology and Transplant Surgery
• Epidemiology of Liver Disease
• Public Health and Healthcare Disparities

Background:

• Non-Alcoholic Steatohepatitis (NASH) is a growing cause of end-stage liver disease.
• Liver transplantation (LT) is a critical treatment for advanced liver disease.
• Understanding trends in NASH-related LT is crucial for resource allocation and future planning.

Purpose of the Study:

• To provide an up-to-date, large-scale overview of Non-Alcoholic Steatohepatitis (NASH) liver transplantation (LT) trends in the United States.
• To compare NASH LT demographics with all other LT indications from 2000 to 2022.
• To identify demographic factors predicting future demand for NASH LT.

Main Methods:

• Analysis of the Organ Procurement & Transplantation Network (OPTN) database from 2000-2022.
• Descriptive statistics and hypothesis testing were employed.
• Trend lines and linear correlations were explored to analyze data.

Main Results:

• NASH LT increased from 0.12% in 2000 to 14.7% in 2022, a 100-fold rise.
• NASH LT recipients are often aged 50-64, with 52% having type 2 diabetes mellitus.
• Ethnic disparities exist, with African Americans underrepresented (2%) in NASH LT, and the East Coast shows higher NASH LT rates.

Conclusions:

• Significant increase in NASH LT necessitates increased resources, especially for minority, uninsured, or noncitizen populations.
• Type 2 diabetes mellitus is a key risk factor for NASH progression to end-stage liver disease.
• The findings offer critical insights into the evolving landscape of liver transplantation for NASH.