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Liver transplantation in patients with nonalcoholic steatohepatitis-related hepatocellular carcinoma.
Clin Gastroenterol Hepatol. 2009 Jul; 7(7):800-6.CG

Abstract

BACKGROUND & AIMS

The increasing incidence of hepatocellular carcinoma in the United States is only partially accounted for by hepatitis C virus (HCV) infections. The prevalence of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis (NASH) is not known; guidelines from the American Association for the Study of Liver Diseases do not recommend surveillance imaging. We sought to determine the prevalence of hepatocellular carcinoma among patients undergoing liver transplantation for NASH-related cirrhosis and their outcome after surgery, compared with controls.

METHODS

We reviewed the records of adult patients with NASH cirrhosis who underwent liver transplantation by using a prospectively collected database from a single center. Data from patients with NASH cirrhosis were compared with matched controls who received transplantation for primary biliary cirrhosis/primary sclerosing cholangitis, alcoholic liver disease, or HCV.

RESULTS

Seventeen of 98 patients (17%) with NASH cirrhosis were diagnosed with hepatocellular carcinoma. The mean age was 63 years, and 70% were male. Six patients were diagnosed with hepatocellular carcinoma incidentally on explant. Survival after liver transplantation was 88% after mean follow-up of 2.5 years. The number of NASH patients known to have hepatocellular carcinoma before liver transplantation was greater than the number of patients with primary biliary cirrhosis/primary sclerosing cholangitis and comparable to the number of patients with alcoholic liver disease and HCV.

CONCLUSIONS

Patients with NASH cirrhosis are at risk for developing hepatocellular carcinoma; patients with NASH cirrhosis, especially men older than 50 years, should undergo surveillance imaging. Patients with NASH and hepatocellular carcinoma have good outcomes after liver transplantation.

Authors+Show Affiliations

Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. maliks@upmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19281869

Citation

Malik, Shahid M., et al. "Liver Transplantation in Patients With Nonalcoholic Steatohepatitis-related Hepatocellular Carcinoma." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 7, no. 7, 2009, pp. 800-6.
Malik SM, Gupte PA, de Vera ME, et al. Liver transplantation in patients with nonalcoholic steatohepatitis-related hepatocellular carcinoma. Clin Gastroenterol Hepatol. 2009;7(7):800-6.
Malik, S. M., Gupte, P. A., de Vera, M. E., & Ahmad, J. (2009). Liver transplantation in patients with nonalcoholic steatohepatitis-related hepatocellular carcinoma. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 7(7), 800-6. https://doi.org/10.1016/j.cgh.2009.02.025
Malik SM, et al. Liver Transplantation in Patients With Nonalcoholic Steatohepatitis-related Hepatocellular Carcinoma. Clin Gastroenterol Hepatol. 2009;7(7):800-6. PubMed PMID: 19281869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Liver transplantation in patients with nonalcoholic steatohepatitis-related hepatocellular carcinoma. AU - Malik,Shahid M, AU - Gupte,Parijat A, AU - de Vera,Michael E, AU - Ahmad,Jawad, Y1 - 2009/03/09/ PY - 2009/01/03/received PY - 2009/02/18/revised PY - 2009/02/26/accepted PY - 2009/3/14/entrez PY - 2009/3/14/pubmed PY - 2009/8/27/medline SP - 800 EP - 6 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 7 IS - 7 N2 - BACKGROUND & AIMS: The increasing incidence of hepatocellular carcinoma in the United States is only partially accounted for by hepatitis C virus (HCV) infections. The prevalence of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis (NASH) is not known; guidelines from the American Association for the Study of Liver Diseases do not recommend surveillance imaging. We sought to determine the prevalence of hepatocellular carcinoma among patients undergoing liver transplantation for NASH-related cirrhosis and their outcome after surgery, compared with controls. METHODS: We reviewed the records of adult patients with NASH cirrhosis who underwent liver transplantation by using a prospectively collected database from a single center. Data from patients with NASH cirrhosis were compared with matched controls who received transplantation for primary biliary cirrhosis/primary sclerosing cholangitis, alcoholic liver disease, or HCV. RESULTS: Seventeen of 98 patients (17%) with NASH cirrhosis were diagnosed with hepatocellular carcinoma. The mean age was 63 years, and 70% were male. Six patients were diagnosed with hepatocellular carcinoma incidentally on explant. Survival after liver transplantation was 88% after mean follow-up of 2.5 years. The number of NASH patients known to have hepatocellular carcinoma before liver transplantation was greater than the number of patients with primary biliary cirrhosis/primary sclerosing cholangitis and comparable to the number of patients with alcoholic liver disease and HCV. CONCLUSIONS: Patients with NASH cirrhosis are at risk for developing hepatocellular carcinoma; patients with NASH cirrhosis, especially men older than 50 years, should undergo surveillance imaging. Patients with NASH and hepatocellular carcinoma have good outcomes after liver transplantation. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/19281869/Liver_transplantation_in_patients_with_nonalcoholic_steatohepatitis_related_hepatocellular_carcinoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(09)00196-7 DB - PRIME DP - Unbound Medicine ER -