Evolving Frequency and Outcomes of Liver Transplantation Based on Etiology of Liver Disease
Abstract
Background In the background of availability of better treatments for specific liver diseases and listing of nonalcoholic steatohepatitis (NASH) as an etiology for liver transplantation (LT), data are unclear on the impact of disease etiology on the frequency of LT and liver posttransplantation outcomes. Methods The United Network for Organ Sharing database (1994-2009) was queried for adults receiving first LT for primary biliary cirrhosis (PBC; n=3052), primary sclerosing cholangitis (PSC; n=3854), hepatitis C virus (HCV; n=15,147), alcoholic cirrhosis (AC; n=8940), HCV+alcohol (n=6066), NASH (n=1368), cryptogenic cirrhosis (CC; n=5856), hepatitis B virus (HBV; n=1816), and hepatocellular carcinoma (HCC; n=8588). Graft and patient survival were compared and Cox models were built to determine independent prediction of outcomes by disease etiology. Results The frequency of LT increased for NASH, HCC, and HCV+alcohol, remained stable for AC, and decreased for PBC, PSC, HCV, CC, and HBV. The proportion of simultaneous liver-kidney transplants increased from approximately 3% in 2001 to 10% in 2009. Compared with PBC, 5-year graft and patient survival were (a) similar for PSC, NASH, and HBV (80-85%), (b) poorer for AC and CC (hazard ratio, 1-1.5), and (c) worst for HCV, HCV+alcohol, and HCC (hazard ratio, 1.5-2.4). Five-year outcomes for HCV-associated HCC were poorer compared with HCC due to other etiologies. Conclusions LT performed for NASH and HCC are increasing. Potent treatm…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
That study reported 1-, 3-, 5-, and 10-year graft survival of 85%, 80%, 78.1%, and 71.9%, and patient survival of 90.2%, 86.7%, 84.4%, and 79%.
“In the same study, the 1-, 3-, 5-, and 10-year graft survival rates were 85%, 80%, 78.1%, and 71.9%, and the 1-, 3-, 5-, and 10-year patient survival rates were 90.2%, 86.7%, 84.4%, and 79%, respectively.(253)”
From Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases (2019) · cites this paper as [253]
Liver transplantation outcomes for PBC are better than for almost all other disease categories.
“The outcome of liver transplantation for patients with PBC is more favorable than for nearly all other disease categories.”
From Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases (2019) · cites this paper as [253]
A recent UNOS database study found that liver transplantation for PBC is decreasing in frequency.
“In a more recent study querying the United Network for Organ Sharing database, the frequency of liver transplantation for PBC was again noted to be decreasing.(253)”
From Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases (2019) · cites this paper as [253]
Cites
Transplantation trends in primary biliary cirrhosis
Lee, J., Belanger, A., Doucette, J. T., Stanca, C., Friedman, S., & Bach, N. (2007) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2007.07.015 · Cited by 147 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Hirschfield, G. M., Beuers, U., Corpechot, C., Invernizzi, P., Jones, D., Marzioni, M., & Schramm, C. (2017) · Journal of Hepatology · doi:10.1016/j.jhep.2017.03.022 · Cited by 1,480 · see citing works
Martin, P., DiMartini, A., Feng, S., Brown, R., & Fallon, M. (2014) · Hepatology · doi:10.1002/hep.26972 · Cited by 1,045 · see citing works
Lindor, K. D., Bowlus, C. L., Boyer, J., Levy, C., & Mayo, M. (2019) · Hepatology · doi:10.1002/hep.30145 · Cited by 913 · see citing works
Thiazolidinediones and Advanced Liver Fibrosis in Nonalcoholic Steatohepatitis: A Meta-analysis
Musso, G., Cassader, M., Paschetta, E., & Gambino, R. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.9607 · Cited by 449 · see citing works
Diagnosis and Treatment of Alcohol-Associated Liver Disease: A Review
Singal, A. K., & Mathurin, P. (2021) · JAMA · doi:10.1001/jama.2021.7683 · Cited by 398 · see citing works
Self-citationPnpla3I148M knockin mice accumulate PNPLA3 on lipid droplets and develop hepatic steatosis
Smagris, E., BasuRay, S., Li, J., Huang, Y., Lai, K. V., Gromada, J., Cohen, J. C., & Hobbs, H. H. (2015) · Hepatology · doi:10.1002/hep.27242 · Cited by 379 · see citing works
Lleo, A., Wang, G.-Q., Gershwin, M. E., & Hirschfield, G. M. (2020) · The Lancet · doi:10.1016/s0140-6736(20)31607-x · Cited by 253 · see citing works
Nonalcoholic fatty liver disease in adults: current concepts in etiology, outcomes, and management
Marjot, T., Moolla, A., Cobbold, J. F., Hodson, L., & Tomlinson, J. W. (2020) · Endocrine Reviews · doi:10.1210/endrev/bnz009 · Cited by 228 · see citing works
Depression and chronic liver diseases: are there shared underlying mechanisms?
Huang, X., Liu, X., & Yu, Y. (2017) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2017.00134 · Cited by 121 · see citing works
Timing, management, and outcomes of liver transplantation in primary sclerosing cholangitis
Levy, C., & Martin, E. (2017) · Seminars in Liver Disease · doi:10.1055/s-0037-1608655 · Cited by 46 · see citing works
Rupp, C., Bode, K. A., Chahoud, F., Wannhoff, A., Friedrich, K., Weiss, K.-H., Sauer, P., Stremmel, W., & Gotthardt, D. N. (2014) · BMC Infectious Diseases · doi:10.1186/s12879-014-0562-8 · Cited by 38 · see citing works
Maleki, I. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i35.12566 · Cited by 22 · see citing works
- Authors
- Singal, A. K., Guturu, P., Hmoud, B., Kuo, Y.-F., Salameh, H., & Wiesner, R. H.
- Affiliations
- Mayo Clinic (US)
- The University of Texas Medical Branch at Galveston (US)
- Corresponding author
- Singal, Ashwani K.
- Venue
- Transplantation
- Published
- 2013-03-15
- Volume
- 95
- Issue
- 5
- Pages
- 755-760
- ISSN
- 0041-1337 (ISSN-L)
- OpenAlex
- W2324221245
- Cited by
- 278
- References
- 1
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 12 · 2023: 13 · 2022: 18 · 2021: 20 · 2020: 26 · 2019: 26 · 2018: 27 · 2017: 27 · 2016: 29 · 2015: 27 · 2014: 29 · 2013: 17
- FWCI
- 33.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- liver transplantation, liver disease etiology, nonalcoholic steatohepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, hepatitis C virus, alcoholic cirrhosis, cryptogenic cirrhosis, hepatitis B virus, hepatocellular carcinoma, graft survival, patient survival, combined liver-kidney transplantation, transplant trends
- MeSH terms
- Adult, Fatty Liver, Graft Survival, Humans, Liver Cirrhosis, Biliary, Liver Diseases, Liver Neoplasms, Proportional Hazards Models, Liver Transplantation, Treatment Outcome, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
