Nonalcoholic fatty liver disease is an increasing indication for liver transplantation in the Nordic countries

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Holmer , M , Melum , E , Isoniemi , H , Ericzon , B-G , Castedal , M , Nordin , A , Schultz , N A , Rasmussen , A , Line , P-D , Stål , P , Bennet , W & Hagström , H 2018 , ' Nonalcoholic fatty liver disease is an increasing indication for liver transplantation in the Nordic countries ' , Liver International , vol. 38 , no. 11 , pp. 2082-2090 . https://doi.org/10.1111/liv.13751

Title: Nonalcoholic fatty liver disease is an increasing indication for liver transplantation in the Nordic countries
Author: Holmer, Magnus; Melum, Espen; Isoniemi, Helena; Ericzon, Bo-Göran; Castedal, Maria; Nordin, Arno; Schultz, Nicolai Aagaard; Rasmussen, Allan; Line, Pal-Dag; Stål, Per; Bennet, William; Hagström, Hannes
Other contributor: University of Helsinki, IV kirurgian klinikka
University of Helsinki, IV kirurgian klinikka



Date: 2018-11
Language: eng
Number of pages: 9
Belongs to series: Liver International
ISSN: 1478-3223
DOI: https://doi.org/10.1111/liv.13751
URI: http://hdl.handle.net/10138/306616
Abstract: Background & Aims Nonalcoholic fatty liver disease(NAFLD) is the second most common cause of liver transplantation in the US. Data on NAFLD as a liver transplantation indication from countries with lower prevalences of obesity are lacking. We studied the temporal trends of NAFLD as an indication for liver transplantation in the Nordic countries, and compared outcomes for patients with NAFLD to patients with other indications for liver transplantation. MethodResultsPopulation-based cohort study using data from the Nordic Liver Transplant Registry on adults listed for liver transplantation between 1994 and 2015. NAFLD as the underlying indication for liver transplantation was defined as a listing diagnosis of NAFLD/nonalcoholic steatohepatitis, or cryptogenic cirrhosis with a body mass index 25kg/m(2) and absence of other liver diseases. Waiting time for liver transplantation, mortality and withdrawal from the transplant waiting list were registered. Survival after liver transplantation was calculated using multivariable Cox regression, adjusted for age, sex, body mass index and model for end-stage liver disease. A total of 4609 patients listed for liver transplantation were included. NAFLD as the underlying indication for liver transplantation increased from 2.0% in 1994-1995 to 6.2% in 2011-2015 (P=.01) and was the second most rapidly increasing indication. NAFLD patients had higher age, model for end-stage liver disease and body mass index when listed for liver transplantation, but overall survival after liver transplantation was comparable to non--NAFLD patients (aHR 1.03, 95% CI 0.70-1.53 P=.87). ConclusionNAFLD is an increasing indication for liver transplantation in the Nordic countries. Despite more advanced liver disease, NAFLD patients have a comparable survival to other patients listed for liver transplantation.
Subject: Liver cirrhosis
NASH
NLTR
obesity
TERM-FOLLOW-UP
UNITED-STATES
HEPATOCELLULAR-CARCINOMA
STEATOHEPATITIS
CIRRHOSIS
OUTCOMES
MORTALITY
FIBROSIS
SURVIVAL
OBESITY
3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
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