Contact: Dawn Peters
driven by liver cancer development in baby boomers
New research reveals that the greatest demand for liver
transplantation due to hepatitis C (HCV)-related liver disease occurs among
Americans born between 1941 and 1960. Findings in the December issue of Liver
Transplantation, a journal published by Wiley on behalf of the American
Association for the Study of Liver Diseases (AASLD), suggest that continuing
increased demand for transplantation is driven by the development of liver
cancer in baby boomers with HCV, but that the demand may decrease as patients
born in this time period continue to grow older.
HCV is the most common blood-borne infection and cause of liver
disease requiring transplantation in the U.S., chronically infecting more than
one percent of Americans. Previous studies show that among patients living with
chronic HCV, 10% to 20% will develop cirrhosis and up to 5% will progress to
liver cancer (hepatocellular carcinoma; HCC). Further evidence implicates HCV as
the primary risk factor for developing HCC in up to 47% of cases of patients
The peak U.S. HCV prevalence of 4% occurred in those born in
1940 through 1965, who were 20 to 30 years of age during 1979 to 1989, when HCV
infection risk was at its highest. As this population ages, Davis et al. project
that between 2000 and 2030 cirrhosis in patients with HCV will increase
two-fold, from 472,000 to 879,000. Moreover, Wise et al. suggests HCV-related
deaths will increase in Americans 55 to 64 years of age by 2004.
"The dire projections in HCV complications spurred our
investigation of age-specific trends in liver transplantation demand," said lead
author Dr. Scott Biggins with the University of Colorado School of Medicine in
Aurora, Colo. For the present study, researchers identified all adult liver
transplant candidates who were registered with the Organ Procurement and
Transplantation Network (OPTN) between 1995 and 2010. Patients were then
classified with the diagnosis of HCV, with or without HCC.
Results show there were 126,862 new candidates for first liver
transplant registered with OPTN, with 41% of these having HCV. Candidates were
categorized by birth year and found that the highest HCV frequency (in
decreasing order) were those born in 1951-1955, 1956-1960, 1946-1950, and
1941-1945. These four birth groups represent 81% of all new liver transplant
registrants with HCV.
Furthermore, findings indicate that between 2000 and 2010 there
was a four-fold increase in new transplant candidates with HCV and HCC in the
1941 to 1960 birth cohorts. The authors anticipate an increase in the proportion
of new registrants, 60 years and older, with HCV will have liver cancer.
"Over the coming decade the aging of those infected with HCV
will challenge the transplant community to reconsider current treatment plans
given the projected increase in liver transplantation demand, particularly from
patients with HCV and liver cancer," concludes Dr. Biggins. "With the aging of
the population of patients with HCV, many of these patients may not be healthy
enough for transplantation and the number of liver transplants in patients with
HCV may decrease."
This study was funded in part by grants from the National Center
for Research Resources, the National Institute of Diabetes and Digestive and
Kidney Diseases, and the Agency for Healthcare Research and Quality.
This study is published in Liver Transplantation. Media
wishing to receive a PDF of the article may contact firstname.lastname@example.org.
Full citation:"Projected Future Increase in Aging HCV-Infected Liver
Transplant Candidates: A Potential Effect of HCC." Scott W. Biggins, Kiran M.
Bambha, Norah A. Terrault, John Inadomi, Stephen Shiboski, Jennifer L. Dodge,
Jane Gralla, Hugo R. Rosen and John P. Roberts. Liver Transplantation;
Print Issue Date: December, 2012.
Author Contact: Media wishing to speak with Dr. Biggins may contact Dan Meyers
with the University of Colorado School of Medicine at email@example.com or
Liver Transplantationis published by Wiley on behalf of the American Association for
the Study of Liver Diseases and the International Liver Transplantation Society.
Since the first application of liver transplantation in a clinical situation was
reported more than twenty years ago, there has been a great deal of growth in
this field and more is anticipated. As an official publication of the AASLD and
the ILTS, Liver Transplantation delivers current, peer-reviewed articles on
surgical techniques, clinical investigations and drug research — the information
necessary to keep abreast of this evolving specialty. For more information,
please visit http://wileyonlinelibrary.com/journal/livertransplantation.
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