The changing epidemiology of adult liver transplantation in the United States in 2013-2022: The dominance of metabolic dysfunction–associated steatotic liver disease and alcohol-associated liver disease
Zobair M. Younossi, Maria Stepanova, Reem Al Shabeeb, Katherine E. Eberly, Dipam Shah, Veronica Nguyen, Janus Ong, Linda Henry, Saleh A. Alqahtani- Hepatology
Background:
The high prevalence of obesity in the United States drives the burden of NASH, recently renamed as metabolic dysfunction–associated steatohepatitis (MASH). We assessed the most recent trends in liver transplantation in the United States.
Methods:
The Scientific Registry of Transplant Recipients (SRTR 2013-2022) was used to select adult (18 years or above) candidates who underwent liver transplant.
Results:
There were 116,292 candidates who underwent liver transplant with known etiology of chronic liver disease. In candidates without HCC, the most common etiology was alcohol-associated liver disease (ALD), increasing from 23% (2013) to 48% (2022), followed by NASH/MASH, which increased from 19% to 27%; the rates of viral hepatitis decreased (chronic hepatitis C: 28%–4%; chronic hepatitis B: 1.8%–1.1%) (all trend
Conclusions:
Liver transplant etiologies in the United States have changed over the last decade. Alcohol-associated liver disease and NASH/MASH remain the 2 most common indications for transplantation among those without HCC, and NASH/MASH is the most common in patients with HCC.