Trends in Waiting List Registration for Liver Transplantation for Viral Hepatitis in the United States

W. Ray Kim, Norah A. Terrault, Rachel A. Pedersen, Terry M Therneau, Erick Edwards, Andrew A. Hindman, Carol L. Brosgart

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

Background & Aims: In the last decade, significant progress has been made in the treatment of liver disease associated with chronic hepatitis, especially in patients infected with the hepatitis B virus (HBV). To investigate whether the population-wide application of antiviral therapies has impacted liver transplant waiting list registration, we analyzed longitudinal trends in waiting list registration for patients with hepatitis B and C and those with nonviral liver disease. Methods: This study represented a retrospective analysis of registry data containing all US liver transplant centers. All adult, primary liver transplantation candidates registered to the Organ Procurement and Transplantation Network between 1985 and 2006 were included in the analysis. Standardized incidence rates were calculated for waiting list registration for liver transplantation by underlying disease (HBV and HCV infection and other) and by indication for transplantation (fulminant liver disease, hepatocellular carcinoma [HCC], and end-stage liver disease [ESLD]). Results: Of 113,927 unique waiting list registrants, 4793 (4.2%) had HBV, and 40,923 (35.9%) had HCV infections; the remaining 68,211 (59.9%) had neither. The incidence of waiting list registration for ESLD and fulminant liver disease decreased, whereas that for HCC increased. The decrease in ESLD registration was most pronounced, and the increase in HCC was least dramatic among registrants with hepatitis B. The decrease in registration for ESLD secondary to HCV infection was also significantly larger than that for ESLD patients with nonviral etiologies. Conclusions: The pattern of liver transplantation waiting list registration among patients with hepatitis B suggests that the widespread application of oral antiviral therapy for HBV contributed to the decreased incidence of decompensated liver disease.

Original languageEnglish (US)
Pages (from-to)1680-1686
Number of pages7
JournalGastroenterology
Volume137
Issue number5
DOIs
StatePublished - Nov 2009

Fingerprint

Waiting Lists
End Stage Liver Disease
Liver Transplantation
Hepatitis
Liver Diseases
Hepatitis B virus
Hepatitis B
Hepatocellular Carcinoma
Antiviral Agents
Incidence
Transplants
Tissue and Organ Procurement
Liver
Organ Transplantation
Virus Diseases
Chronic Hepatitis
Hepatitis C
Infection
Registries
Therapeutics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Kim, W. R., Terrault, N. A., Pedersen, R. A., Therneau, T. M., Edwards, E., Hindman, A. A., & Brosgart, C. L. (2009). Trends in Waiting List Registration for Liver Transplantation for Viral Hepatitis in the United States. Gastroenterology, 137(5), 1680-1686. https://doi.org/10.1053/j.gastro.2009.07.047

Trends in Waiting List Registration for Liver Transplantation for Viral Hepatitis in the United States. / Kim, W. Ray; Terrault, Norah A.; Pedersen, Rachel A.; Therneau, Terry M; Edwards, Erick; Hindman, Andrew A.; Brosgart, Carol L.

In: Gastroenterology, Vol. 137, No. 5, 11.2009, p. 1680-1686.

Research output: Contribution to journalArticle

Kim, WR, Terrault, NA, Pedersen, RA, Therneau, TM, Edwards, E, Hindman, AA & Brosgart, CL 2009, 'Trends in Waiting List Registration for Liver Transplantation for Viral Hepatitis in the United States', Gastroenterology, vol. 137, no. 5, pp. 1680-1686. https://doi.org/10.1053/j.gastro.2009.07.047
Kim, W. Ray ; Terrault, Norah A. ; Pedersen, Rachel A. ; Therneau, Terry M ; Edwards, Erick ; Hindman, Andrew A. ; Brosgart, Carol L. / Trends in Waiting List Registration for Liver Transplantation for Viral Hepatitis in the United States. In: Gastroenterology. 2009 ; Vol. 137, No. 5. pp. 1680-1686.
@article{95486d446694486f8273812fbe21c41d,
title = "Trends in Waiting List Registration for Liver Transplantation for Viral Hepatitis in the United States",
abstract = "Background & Aims: In the last decade, significant progress has been made in the treatment of liver disease associated with chronic hepatitis, especially in patients infected with the hepatitis B virus (HBV). To investigate whether the population-wide application of antiviral therapies has impacted liver transplant waiting list registration, we analyzed longitudinal trends in waiting list registration for patients with hepatitis B and C and those with nonviral liver disease. Methods: This study represented a retrospective analysis of registry data containing all US liver transplant centers. All adult, primary liver transplantation candidates registered to the Organ Procurement and Transplantation Network between 1985 and 2006 were included in the analysis. Standardized incidence rates were calculated for waiting list registration for liver transplantation by underlying disease (HBV and HCV infection and other) and by indication for transplantation (fulminant liver disease, hepatocellular carcinoma [HCC], and end-stage liver disease [ESLD]). Results: Of 113,927 unique waiting list registrants, 4793 (4.2{\%}) had HBV, and 40,923 (35.9{\%}) had HCV infections; the remaining 68,211 (59.9{\%}) had neither. The incidence of waiting list registration for ESLD and fulminant liver disease decreased, whereas that for HCC increased. The decrease in ESLD registration was most pronounced, and the increase in HCC was least dramatic among registrants with hepatitis B. The decrease in registration for ESLD secondary to HCV infection was also significantly larger than that for ESLD patients with nonviral etiologies. Conclusions: The pattern of liver transplantation waiting list registration among patients with hepatitis B suggests that the widespread application of oral antiviral therapy for HBV contributed to the decreased incidence of decompensated liver disease.",
author = "Kim, {W. Ray} and Terrault, {Norah A.} and Pedersen, {Rachel A.} and Therneau, {Terry M} and Erick Edwards and Hindman, {Andrew A.} and Brosgart, {Carol L.}",
year = "2009",
month = "11",
doi = "10.1053/j.gastro.2009.07.047",
language = "English (US)",
volume = "137",
pages = "1680--1686",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Trends in Waiting List Registration for Liver Transplantation for Viral Hepatitis in the United States

AU - Kim, W. Ray

AU - Terrault, Norah A.

AU - Pedersen, Rachel A.

AU - Therneau, Terry M

AU - Edwards, Erick

AU - Hindman, Andrew A.

AU - Brosgart, Carol L.

PY - 2009/11

Y1 - 2009/11

N2 - Background & Aims: In the last decade, significant progress has been made in the treatment of liver disease associated with chronic hepatitis, especially in patients infected with the hepatitis B virus (HBV). To investigate whether the population-wide application of antiviral therapies has impacted liver transplant waiting list registration, we analyzed longitudinal trends in waiting list registration for patients with hepatitis B and C and those with nonviral liver disease. Methods: This study represented a retrospective analysis of registry data containing all US liver transplant centers. All adult, primary liver transplantation candidates registered to the Organ Procurement and Transplantation Network between 1985 and 2006 were included in the analysis. Standardized incidence rates were calculated for waiting list registration for liver transplantation by underlying disease (HBV and HCV infection and other) and by indication for transplantation (fulminant liver disease, hepatocellular carcinoma [HCC], and end-stage liver disease [ESLD]). Results: Of 113,927 unique waiting list registrants, 4793 (4.2%) had HBV, and 40,923 (35.9%) had HCV infections; the remaining 68,211 (59.9%) had neither. The incidence of waiting list registration for ESLD and fulminant liver disease decreased, whereas that for HCC increased. The decrease in ESLD registration was most pronounced, and the increase in HCC was least dramatic among registrants with hepatitis B. The decrease in registration for ESLD secondary to HCV infection was also significantly larger than that for ESLD patients with nonviral etiologies. Conclusions: The pattern of liver transplantation waiting list registration among patients with hepatitis B suggests that the widespread application of oral antiviral therapy for HBV contributed to the decreased incidence of decompensated liver disease.

AB - Background & Aims: In the last decade, significant progress has been made in the treatment of liver disease associated with chronic hepatitis, especially in patients infected with the hepatitis B virus (HBV). To investigate whether the population-wide application of antiviral therapies has impacted liver transplant waiting list registration, we analyzed longitudinal trends in waiting list registration for patients with hepatitis B and C and those with nonviral liver disease. Methods: This study represented a retrospective analysis of registry data containing all US liver transplant centers. All adult, primary liver transplantation candidates registered to the Organ Procurement and Transplantation Network between 1985 and 2006 were included in the analysis. Standardized incidence rates were calculated for waiting list registration for liver transplantation by underlying disease (HBV and HCV infection and other) and by indication for transplantation (fulminant liver disease, hepatocellular carcinoma [HCC], and end-stage liver disease [ESLD]). Results: Of 113,927 unique waiting list registrants, 4793 (4.2%) had HBV, and 40,923 (35.9%) had HCV infections; the remaining 68,211 (59.9%) had neither. The incidence of waiting list registration for ESLD and fulminant liver disease decreased, whereas that for HCC increased. The decrease in ESLD registration was most pronounced, and the increase in HCC was least dramatic among registrants with hepatitis B. The decrease in registration for ESLD secondary to HCV infection was also significantly larger than that for ESLD patients with nonviral etiologies. Conclusions: The pattern of liver transplantation waiting list registration among patients with hepatitis B suggests that the widespread application of oral antiviral therapy for HBV contributed to the decreased incidence of decompensated liver disease.

UR - http://www.scopus.com/inward/record.url?scp=70350089249&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70350089249&partnerID=8YFLogxK

U2 - 10.1053/j.gastro.2009.07.047

DO - 10.1053/j.gastro.2009.07.047

M3 - Article

C2 - 19632234

AN - SCOPUS:70350089249

VL - 137

SP - 1680

EP - 1686

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 5

ER -