Table 1.
Outcomes of liver transplantation in severe MASLD patients.
| Study | N | Survival | MASH | Non-MASH | CC | HCV | HBV | AIH | ALD | PSC |
|---|---|---|---|---|---|---|---|---|---|---|
| Large database studies | ||||||||||
| Charlton et al. [36] Period: 2001–2009 Data source: SRTR |
35,781 LT; 1959 MASH | 1 y | 84% | 87% | 86% | • | • | • | • | • |
| 3 y | 78% | 78% | 79% | • | • | • | • | • | ||
| Karnam et al. [39]. Period: 2002–2019 Data source: SRTR |
6515 LT for MASH cirrhosis | 5 y | 79% | • | • | • | • | • | • | • |
| Younossi et al. [40]. Period: 2002–2016 Data source: SRTR |
158,347 LT candidates due to HCC | 1 y (mortality) | 10.6% | • | • | 10.6% | 8.1% | 8.6% | • | • |
| 3 y (mortality) | 19.7% | • | • | 24.4% | 16.7% | 19.9% | • | • | ||
| 5 y (mortality) | 28.2% | • | • | 34.9% | 21.5% | 31.3% | • | • | ||
| Afzali et al. [41] Period: 1997 to 2010 Data source: UNOS |
69,962 LT; 1810 were MASH recipients | 1 y | 87.6% | • | • | • | • | • | • | • |
| 3 y | 82.2% | • | • | • | • | • | • | • | ||
| 5 y | 76.7% | • | • | • | • | • | • | • | ||
| Singal et al. [42] Period: 1994–2009 Data source: UNOS |
54,687 LT; 1358 were due to MASH cirrhosis | 1 y | 88.8% | 86.9% | 87.2% | 89.5% | • | • | 88.6% | 93.4% |
| 3 y | 85.4% | 82.4% | 79.9% | 84.5% | • | • | 83% | 89.7% | ||
| 5 y | 84.1% | 78.6% | 75.9% | 82.4% | • | • | 79.4% | 87.4% | ||
| 10 y | 84.1% | 78.6% | 75.9% | 82.4% | • | • | 79.4% | 87.4% | ||
| Thuluuath et al. [43]. Period: 2002–2019 Data source: UNOS |
Cryptogenic (3241 patients) and MASH (4089 patients) cirrhosis | 30 d | 97% | • | 96% | • | • | 96% | 97% | • |
| 1 y | 89% | • | 87% | • | • | 88% | 90% | • | ||
| 2 y | 86% | • | 85% | • | • | 86% | 88% | • | ||
| 3 y | 83% | • | 82% | • | • | 84% | 84% | • | ||
| 5 y | 77% | • | 77% | • | • | 79% | 78% | • | ||
| 10 y | 63% | • | 61% | • | • | 65% | 60% | • | ||
| Cholankeril et al. [44]. Period: 2003–2014 Data source UNOS/OPTN |
63,061 LT, including 20782 HCV (32.96%) | 5 y | 77,81% | • | • | 72,15% | • | • | • | • |
| Rajendran et al. [45]. Period: 2001–2009 Data source: UNOS |
35,781 LT, of which 1959 were MASH | 1 y | 84% | 87% | • | • | • | • | • | • |
| 3 y | 78% | 78% | • | • | • | • | • | • | ||
| Kwong et al. [46]. Period: 2010–2016 Data source: REALT |
1023 LT, of which 207 (20.2%) were due to MASH cirrhosis | 1 y | 91.3% | 90.1% | • | • | • | • | • | • |
| 3 y | 83.3% | 81.5% | • | • | • | • | • | • | ||
| Haldar et al. [47] Period: 2002–2016 Data source: ELTR |
68,950 LT and 2741 MASH recipients | 1 y | 84.1% | 86.2% | • | • | • | • | • | • |
| 2.5 y | 80.2% | 81.6% | • | • | • | • | • | • | ||
| 5 y | 73.4% | 75.4% | • | • | • | • | • | • | ||
| 10 y | 62.1% | 62.9% | • | • | • | • | • | • | ||
| Jamil et al. [48]. Period: 2005–2019 Data source: SRTR |
Over 80,000 LT | 10 y | 61% | • | • | • | • | • | • | • |
| Nagai et al. [49]. Period: 2016–2018 Data source: OPTN/UNOS |
6344 LT for MASH, 17,037 for HCV, and 9279 for ALD | 1 y | 90.4% | • | • | 92.8% | • | • | • | • |
| Single-center studies | ||||||||||
| VanWagner et al. [50]. Period: 1993–2010 Data source: Northwestern Memorial Hospital and the University of Chicago Medical Center |
115 had MASH (or CC with known risk factors for MASH); 127 patients with alcohol-induced cirrhosis | 1 y | 81.3% | • | • | • | • | • | 88.1% | • |
| 3 y | 73.3% | • | • | • | • | • | 85.3% | • | ||
| 5 y | 60.3% | • | • | • | • | • | 68.8% | • | ||
| Kennedy et al. [51]. Period: 1999–2009 Data source: University of Alabama at Birmingham |
129 recipients with MASH and 775 recipients were non-MASH | 1 y | 90% | 92% | • | • | • | • | • | • |
| 3 y | 88% | 86% | • | • | • | • | • | • | ||
| 5 y | 85% | 80% | • | • | • | • | • | • | ||
| Malik et al. [52]. Period: 1997–2008 Data source: University of Pittsburgh School of Medicine |
2021 LT; 98 patients with MASH cirrhosis | 24 h mortality | 4.1% | 1–3% | • | • | • | • | • | • |
| 30 d mortality | 6.1% | 2–5% | • | • | • | • | • | • | ||
| 2 y mortality | 21.4% | 13–18% | • | • | • | • | • | • | ||
| 3 y mortality | 25.5% | 16–30% | • | • | • | • | • | • | ||
| 5 y mortality | 27.6% | 19–35% | • | • | • | • | • | • | ||
| Bhagat et al. [53]. Period: 1997–2007 Data source: University of Miami |
For CC with the MASH phenotype (71 patients) or alcoholic cirrhosis (83 patients) | 1 y | 82% | • | • | • | • | • | 92% | • |
| 3 y | 79% | • | • | • | • | • | 86% | • | ||
| 5 y | 75% | • | • | • | • | • | 86% | • | ||
| 9 y | 62% | • | • | • | • | • | 76% | • | ||
| Sadler et al. [54]. Period: 2004–2014 Data source: University of Toronto and University of California San Francisco |
929 LT were due to HCC and 60 were due to HCC in MASH cirrhosis | 1 y | 98% | 95% | • | • | • | • | • | • |
| 3 y | 96% | 84% | • | • | • | • | • | • | ||
| 5 y | 80% | 78% | • | • | • | • | • | • | ||
| Agopian et al. [55]. Period: 1993–2011 Data source: The University of California, Transplant and Liver Cancer Centers in Los Angeles |
144 adult MASH patients | 1 y | 84% | • | • | • | • | • | • | • |
| 3 y | 75% | • | • | • | • | • | • | • | ||
| 5 y | 70% | • | • | • | • | • | • | • | ||
| Barrit et al. [56]. Period: 2004–2007 Data source: University of North Carolina Hospital |
118 LT, and 18% were due MASH cirrhosis | 30 d | 81% | 95% | • | • | • | • | • | • |
| 1 y | 76% | 83% | • | • | • | • | • | • | ||
| 3 y | 76% | 73% | • | • | • | • | • | • | ||
| El Atrache et al. [57]. Period: 1996–2008 Data source: Henry Ford Hospital, Detroit |
MASH (46 patients) and CC (37 patients) | 10 y | 80% | • | • | • | • | • | • | • |
| Bhati et al. [58]. Period: 1995–2013 Data source: University of Maryland School of Medicine, Baltimore |
103 LT; 48 had MASH cirrhosis | 5 y | 86% | • | • | • | • | • | • | • |
| 10 y | 71% | • | • | • | • | • | • | • | ||
| 15 y | 51% | • | • | • | • | • | • | • | ||
| Sanjeevi et al. [59]. Period: 2016–2018 Data source: University of Nebraska Medical |
71 MASH patients, and 6 of them had HCC | 1 y | 87.6% | • | • | • | • | • | • | • |
| 3 y | 82.2% | • | • | • | • | • | • | • | ||
| 5 y | 76.7% | • | • | • | • | • | • | • | ||
| Holzner et al. [60]. Period: 2001–2017 Data source: School of Medicine at Mount Sinai, New York |
635 LT, of which 51 (8%) were MASH-HCC | 1 y | 92% | • | • | 86% | 93% | • | 88% | • |
| 3 y | 86% | • | • | 76% | 87% | • | 76% | • | ||
| 5 y | 80% | • | • | 65% | 83% | • | 69% | • | ||
| Kakar et al. [61]. Period: 2000–2015 Data source: University of Pittsburgh |
226 patients with MASH | 1 y | 82% | • | • | • | • | • | • | • |
| 5 y | 73% | • | • | • | • | • | • | • | ||
| 7 y | 62% | • | • | • | • | • | • | • | ||
| Yalamanchili et al. [62]. Period: 1986–2004 Data source: Baylor University Medical Center, Dallas |
2052 LT; 7% for MASH (the cohort of MASH patients were with CC) |
1 y | 85.6% | 86.3% | • | • | • | • | • | • |
| 5 y | 71.4% | 69.9% | • | • | • | • | • | • | ||
| 10 y | 56.5% | 52.7% | • | • | • | • | • | • | ||
| 20 y | 12.6% | 20.6% | • | • | • | • | • | • | ||
| Kern et al. [63]. Period: 2002–2012 Data source: Medical University of Innsbruck, Austria |
513 LT; 12.7% for MASH cirrhosis | 1 y | 93.2% | • | • | • | • | • | • | • |
| 3 y | 78.5% | • | • | • | • | • | • | • | ||
| 5 y | 72.1% | • | • | • | • | • | • | • | ||
| Castello et al. [64]. Period: 1997–2016 Data source: La Fe University Hospital, Valencia |
1986 LT; 40 (2%) were labelled as MASH-related | 1 y | 89% | • | • | • | • | • | 83% | • |
| 3 y | 89% | • | • | • | • | • | 78% | • | ||
| 5 y | 83% | • | • | • | • | • | 72% | • | ||
| Heuer et al. [65]. Period: 2007–2011 Data source: University Hospital of Essen, Essen, Germany |
432 LT; 40 due MASH-induced cirrhosis | 4 y mortality | 60% | • | • | • | • | • | • | • |
| Tokodai et al. [66]. Period: 2007–2017 Data source: Karolinska University Hospital, Stockholm, Sweden |
694 LT; 27 MASH patients; and 68 ALD patients |
1 y | 89% | • | • | • | • | • | 91% | • |
| Tanaka et al. [67]. Period: 1996–2013 Data source: Japan |
425 living-donor LT; 7 due to MASH | 5.3 y | 100% | • | • | • | • | • | • | • |
| Jothimani et al. [68]. Period: 2009–2019 Data source: Bharath Institute of Higher Education and Research; India |
1017 LT, of whom 396 had MASH cirrhosis | 1 y | 86.6% | • | • | 91.3% | 93.5% | • | 86% | • |
| 3 y | 81.8% | • | • | 86.1% | 88.5% | • | 82.9% | • | ||
| 5 y | 75.9% | • | • | 86.1% | 88.5% | • | 79.7% | • | ||
MASH—metabolic dysfunction-associated steatohepatitis; MASLD—metabolic dysfunction-associated steatotic liver disease; UNOS—United Network of Organ Sharing; HCC—hepatocellular carcinoma; LT—liver transplantation; ILTS—International Liver Transplantation Society; CC—cryptogenic cirrhosis; SRTR—Scientific Registry of Transplant Recipients; HBV—hepatitis B virus; AIH—autoimmune hepatitis; PSC—primary sclerosing cholangitis; ALD—alcohol liver disease; PBC—primary biliary cirrhosis; OPTN—Organ Procurement and Transplantation; REALT—Re-Evaluating Age Limits in Transplantation; ELTR—European Liver Transplant Registry; •—not recorded.