Evidence of bias during liver transplant evaluation of non-alcoholic steatohepatitis cirrhosis patients

Liver International : Official Journal of the International Association for the Study of the Liver
Christopher J DanfordMichelle Lai

Abstract

Cardiovascular disease (CVD) is the leading cause of death among non-alcoholic steatohepatitis (NASH) patients and a major source of post-transplant mortality. We sought to examine the effect of comorbidities on listing for orthotopic liver transplant (OLT) in NASH patients. In this retrospective cohort study, we included all patients (n = 955) referred to Beth Israel Deaconess Medical Center for OLT between January 2002 and September 2011 and followed their outcomes through March 2018. Compared with non-NASH patients (n = 881), NASH patients (n = 74) were older, more likely female, more overweight, with higher rates of diabetes, hypertension and CVD. NASH patients were less likely to be listed for OLT (55% vs 68.9%, P = 0.01) and were more often declined for 'medical comorbidities' (36.1% vs 15.7%, P < 0.001). However, on multivariate analysis, the only significant predictors of listing were model for end-stage liver disease (MELD) score (OR 1.04, P = 0.01), HCC (OR 2.16, P = 0.01), and diagnosis of non-NASH cirrhosis (OR 2.56, P = 0.003) while controlling for comorbidities. NASH patients declined for OLT died primarily from their liver disease and were not more likely to die from CVD than non-NASH patients. There was no diffe...Continue Reading

References

Nov 27, 2004·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jeffrey D BrowningHelen H Hobbs
May 17, 2011·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jacqueline G O'LearyGary L Davis
Sep 21, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Anita AfzaliGeorge N Ioannou
Aug 14, 2012·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Christopher KennedyDerek A DuBay
Jul 22, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Lisa B VanWagnerDonald M Lloyd-Jones
May 16, 2015·Liver International : Official Journal of the International Association for the Study of the Liver·Lisa B VanWagnerMary E Rinella
Dec 29, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Zobair M YounossiMark Wymer
Feb 6, 2017·Gastroenterology·Nynke SimonsMartijn C G J Brouwers
Feb 7, 2018·Hepatology Communications·Zobair M YounossiZachary Goodman

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Citations

Mar 23, 2019·International Journal of Molecular Sciences·Reina SasakiMitsuhiko Moriyama
Feb 9, 2020·Gastroenterology Clinics of North America·Naga Swetha SamjiSanjaya K Satapathy
Jun 8, 2021·Canadian Journal of Gastroenterology & Hepatology·Lubomir SkladanyTomas Koller
Sep 27, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Peter J AltshulerAdam S Bodzin
Nov 23, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Aleah L Brubaker, Rohit Loomba

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