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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By Jules Murtha | Fact-checked by Barbara Bekiesz 
| Updated April 25, 2022 MD Linx

Key Takeaways

• Factors such as poverty and low access to education and healthcare are primary contributors to healthcare-related disparities among US sociocultural and economic minorities.
  
• Cultural competency gives physicians a skill set for working with patients of various cultural backgrounds in order to ensure better health outcomes.
  
• Residents can foster cultural competency by familiarizing themselves with the local community, recognizing associated economic and cultural barriers, and addressing implicit biases that may exist toward minority patients.
  

As a resident, you may be privy to the very real effects that social determinants of health have on certain patients. A patient’s language and culture, after all, are known indicators of the quality of care they will likely receive from healthcare providers—and racial and ethnic minorities often suffer as a result.
One way to improve patient care for minorities is by practicing cultural competence and cultural safety.

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​Healio Gastroenterology  May 31st 2022

Alcohol-related deaths have climbed steadily over the past two decades, and with the onset of the COVID-19 pandemic, alcohol-associated disease and mortality rates have continued to soar.
“It is clear that there has been an increase in hospitalizations for alcohol-associated hepatitis, at least at large tertiary centers,” Douglas Simonetto, MD, associate professor of medicine and director of gastroenterology and hepatology fellowship program at the Mayo Clinic in Minnesota, said, noting an increase in alcohol-associated hepatitis particularly among young adults and women in his practice. “There are a few studies already published showing this trend, and we are seeing the same here in Rochester.”

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