Alcoholic cirrhosis is most common liver transplant indication in young U.S. adults

Published June 21, 2022 | Originally published on Reuters Health Medical News

Alcohol-associated liver disease is now the most common indication for liver transplant wait-listing among young American adults, researchers say.
From 2003 to 2018, the diagnosis of alcoholic liver disease (ALD) as an indication for wait-listing for liver transplant in the U.S. increased 4-fold (from 0.03/100,000 to 0.13/100,000) in people ages 20-39, they found.
In a report published in Transplantation, the researchers note that during the COVID-19 pandemic, alcohol sales increased most in young adults and in households with dependent children. The increase in wait-listing for ALD in young adults, however, and particularly in young women, may be due to a number of factors, they say. They note that the gender gap for alcohol consumption has narrowed, that women are more likely to have harmful effects of alcohol at lower levels of exposure compared to men, and that there may be more barriers to treatment of alcohol abuse in women.
In order to describe rates of liver transplant wait-listing stratified by age, sex, and indication, George Philip and colleagues from the Queen's University, Kingston, Ontario, Canada reviewed data from the Scientific Registry of Transplant Recipients on 209,399 individuals who were listed for primary liver transplant between 2003 and 2018. The majority were male (68%) and white (85%). The most common indications for listing were hepatitis C virus (HCV; 47%), followed by ALD (19%) and non-alcoholic fatty liver disease (NAFLD; 18%).
Overall, 10,326 (5%) were between 20 and 39 years of age at the time of listing. Compared to patients who were at least 40 years old when placed on the waiting list, these younger adults were more likely to be listed for autoimmune liver disease (AILD; 40% vs 8%) and ALD (25% vs 19%) and less likely to be listed with HCV (14% vs 47%) or NAFLD (14% versus 18%).
The average annual increase in the number of patients wait-listed was 2% per year in those aged 20 to 39 (IRR, 1.02; P<0.001) and 4% per year in those aged 40 or older (IRR, 1.04; P<0.001).

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