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

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Southern Medical Journal Pub Date : 2024-06-01 DOI:10.14423/SMJ.0000000000001699

Tokunbo Ajayi, Gina Moon, Sixia Chen, Steven Pan, Abdul Oseini, Courtney Houchen

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引用次数: 0

Abstract

Objectives: Our aim was to provide an up-to-date, large-scale overview of the trends and clinicodemographics for NASH LTs performed in the United States compared with all other LT indications between 2000 and 2022. We also examined the demographic factors that will predict future demand for NASH LT.

Methods: Our analysis of NASH LT from the Organ Procurement & Transplantation Network database spanning 2000-2022 consisted primarily of descriptive statistics and hypothesis testing with corrections for multiple testing when necessary. Trend lines and linear correlations were also explored.

Results: NASH LTs have experienced a remarkable surge, escalating from 0.12% of all LTs in 2000 to a substantial 14.7% in 2022, marking a 100-fold increase. Examining demographic trends, a significant proportion of NASH LTs recipients fall within the 50- to 64-year-old age group. Moreover, 52% of these recipients concurrently exhibit type 2 diabetes mellitus, a notably higher percentage than the 19% observed in all LT recipients. Type 2 diabetes mellitus emerges as a prominent risk factor for NASH progressing to end-stage liver disease. The phenomenon of repeat transplantation is noteworthy; although 6% of all LTs necessitate repeat procedures, this figure dramatically drops to 0.6% for NASH LTs. Ethnic disparities are apparent, with African Americans representing a mere 2% of NASH LT recipients, significantly lower than their representation in the overall population. Regionally, the East Coast has a higher proportion of NASH LT recipients compared with waitlist additions. This trend holds true across demographics.

Conclusions: Our findings underscore the need for increased resources, particularly for minority, uninsured, or noncitizen individuals requiring LT for NASH. This analysis provides valuable insights into the dynamic landscape of LTs in the context of NASH, shaping the trajectory of medical interventions in the 21st century.

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2000-2022年非酒精性脂肪性肝炎肝移植手术激增：一项国家数据库研究。

目的：我们的目的是对 2000 年至 2022 年期间在美国进行的 NASH LT 与所有其他 LT 适应症相比的趋势和临床人口统计学进行最新的大规模概述。我们还研究了预测 NASH LT 未来需求的人口统计学因素：我们对器官获取与移植网络数据库中 2000-2022 年间 NASH LT 的分析主要包括描述性统计和假设检验，必要时进行多重检验校正。此外还探讨了趋势线和线性相关关系：NASH腰椎间盘突出症患者人数激增，从2000年占所有腰椎间盘突出症患者的0.12%上升到2022年的14.7%，增长了100倍。从人口趋势来看，大部分 NASH LTs 患者属于 50 至 64 岁年龄组。此外，52%的患者同时患有2型糖尿病，这一比例明显高于所有LT患者中的19%。2型糖尿病是NASH发展为终末期肝病的一个重要风险因素。值得注意的是重复移植现象；尽管在所有LT受者中，有6%需要重复移植，但在NASH LT受者中，这一数字急剧下降至0.6%。种族差异明显，非裔美国人仅占 NASH LT 受者的 2%，明显低于其在总人口中的比例。从地区来看，东海岸的 NASH LT 患者比例高于候补名单上的新增患者。这一趋势在不同的人口统计中都是如此：我们的研究结果强调了增加资源的必要性，尤其是对于需要接受LT治疗的少数民族、无保险或非公民 NASH 患者。这项分析为了解NASH背景下LT的动态变化提供了有价值的见解，塑造了21世纪医疗干预的轨迹。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Southern Medical Journal 医学-医学：内科

CiteScore

1.40

自引率

9.10%

发文量

222

审稿时长

4-8 weeks

期刊介绍： As the official journal of the Birmingham, Alabama-based Southern Medical Association (SMA), the Southern Medical Journal (SMJ) has for more than 100 years provided the latest clinical information in areas that affect patients'' daily lives. Now delivered to individuals exclusively online, the SMJ has a multidisciplinary focus that covers a broad range of topics relevant to physicians and other healthcare specialists in all relevant aspects of the profession, including medicine and medical specialties, surgery and surgery specialties; child and maternal health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices. Each month, articles span the spectrum of medical topics, providing timely, up-to-the-minute information for both primary care physicians and specialists. Contributors include leaders in the healthcare field from across the country and around the world. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.