Steatotic liver disease is the dominant indication for liver transplantation in both Europe and the United States: Trends and outcomes in the past 2 decades

作者：Zobair M. Younossi, Giacomo Germani, Robert L. Wong, Maria Stepanova, Fatema Nader, Vincent Hassan Karam, René A. Adam, Saleh A. Alqahtani, Linda L Henry, Patrizia Burra · 发表于：Liver Transplantation · 年份：2025 · DOI：10.1097/lvt.0000000000000688 · 被引用次数：20 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Organ Transplantation Techniques and Outcomes

Regional differences in liver transplantation (LT) may exist. We described liver transplant populations in the US and European transplant centers over 2 decades. Data from 2 large LT registries: the US Scientific Registry of Transplant Recipients (SRTR) and the European Liver Transplant Registry (ELTR), years 2000-2022, were compared. There were 109,048 recipients of transplant from ELTR (30 countries), 128,765 from SRTR, and a higher proportion of HCC in ELTR (29% vs. 20%). Chronic hepatitis B (9% vs. 3%) and alcohol-associated liver disease (ALD) (30% vs. 23%) occurred more frequently among European recipients of transplant; chronic hepatitis C (18% vs. 27%) and NASH/metabolic dysfunction-associated steatohepatitis (MASH) (7% vs. 19%) for the United States (all p <0.0001). The HCC proportion for both increased (SRTR peak 30% in 2015, SLTR 35% in 2016), then decreased. The most prominent trends for both were increases in ALD and decreases in chronic hepatitis C (trend p <0.0001). NASH/MASH also increased: SRTR 9%-28%, ELTR 5%-12%. From SRTR, NASH/MASH was the common etiology by 2022; ALD was the most common and fastest-growing in ELTR. In patients without HCC, the 3 most common etiologies were identical: ALD, NASH/MASH, and primary sclerosing cholangitis. Predictors of higher post-transplant mortality included earlier calendar year, older recipient's age, male, higher MELD, grade III/IV encephalopathy, having chronic hepatitis C-HCC, older donor's age, small transplant cente...