Table 1.
Characteristics of 48,360 liver transplant recipients in the United States’ Organ Procurement and Transplantation Network (OPTN) database (2002–2011)
| Characteristic | NASH (N = 5,057) |
HCV (N = 14,820) |
Alcohol (N = 6,998) |
Othera (N = 21,485) |
P value |
|---|---|---|---|---|---|
| Recipient Age, mean ± SD, years | 58.1 ± 8.4 | 53.8 ± 7.3 | 53.9 ± 8.6 | 52.9 ± 10.9 | <0.001c,d.e |
| Recipient Female, No (%) | 2197 (43.4) | 4122 (27.8) | 1490 (21.3) | 7349 (34.2) | <0.001c,d,e |
| Recipient Race & Ethnicity, No (%) | |||||
| Non-Hispanic White | 4121 (81.5) | 10421 (70.3) | 5624 (80.4) | 15011 (69.9) | |
| Black | 160 (3.2) | 1694 (11.4) | 261 (3.7) | 2103 (9.8) | |
| Hispanic | 657 (13.0) | 2110 (14.2) | 969 (13.9) | 2617 (12.2) | <0.001c,e, 0.02d |
| Asian | 79 (1.6) | 463 (3.1) | 75 (1.1) | 1526 (7.1) | |
| Other | 40 (0.8) | 132 (0.9) | 69 (1.0) | 228 (1.1) | |
| Socioeconomic status | |||||
| Highest education < High School | 244 (4.8) | 632 (4.3) | 313 (4.5) | 951 (4.4) | 0.09c, 0.36d, 0.22e |
| Working for income | 917 (21.0) | 2890 (25.6) | 901 (16.2) | 5265 (30.7) | <0.001c,d,e |
| Calculated MELD score at transplant | 21.0 ± 9.4 | 18.9 ± 10.3 | 21.7 ± 9.6 | 17.6 ± 10.6 | <0.001c,d,e |
| Waitlist time, mean, days | 241.7 ± 415.3 | 278.4 ± 476.2 | 188.5 ± 389.3 | 304.9 ± 542.0 | <0.001c,d,e |
| Hepatocellular Carcinoma | 327 (6.5) | 2646 (17.9) | 541 (7.7) | 7485 (34.8) | <0.001c,e, 0.008d |
| Simultaneous kidney transplant | 435 (8.6) | 834 (5.6) | 515 (7.4) | 959 (4.5) | <0.001c,e, 0.01d |
| Recipient BMI (kg/m2) at transplant | 32.0 ± 5.8 | 28.3 ± 5.3 | 28.0 ± 5.4 | 27.3 ± 5.4 | <0.001c,d,e |
| Obesity (BMI ≥ 30) | 3237 (64.0) | 4969 (33.6) | 2249 (32.2) | 5698 (26.5) | <0.001c,d,e |
| Morbid obesity (BMI ≥ 40) | 437 (8.6) | 416 (2.8) | 177 (2.5) | 506 (2.4) | <0.001c,d,e |
| Labs at time of transplant | |||||
| Creatinine (mg/dL) | 1.76 ± 1.41 | 1.53 ± 1.37 | 1.65 ± 1.32 | 1.38 ± 1.24 | <0.001c,d,e |
| Total bilirubin (mg/dL) | 7.01 ± 9.39 | 6.56 ± 9.55 | 8.15 ± 9.74 | 7.70 ± 10.63 | 0.004c, <0.001d,e |
| INR | 1.82 ± 0.89 | 1.80 ± 0.91 | 1.95 ± 1.26 | 1.73 ± 1.16 | 0.11c, <0.001d,e |
| Sodium (mEq/L) | 135.7 ± 5.0 | 135.6 ± 5.2 | 135.0 ± 5.4 | 136.3 ± 5.0 | 0.24c, <0.001d,e |
| Pre-transplant CVD (composite) | 730 (37.7) | 1450 (19.8) | 775 (22.8) | 1623 (17.0) | <0.001c,d,e |
| Angina | 73 (7.0) | 94 (3.0) | 53 (3.2) | 119 (2.7) | <0.001c,d,e |
| Cerebrovascular Disease | 23 (1.2) | 36 (0.5) | 22 (0.7) | 53 (0.6) | <0.001c, 0.04d, 0.002e |
| Hypertension | 676 (35.7) | 1339 (18.6) | 696 (20.9) | 1454 (15.6) | <0.001c,d,e |
| Peripheral Vascular Disease | 33 (1.8) | 62 (0.9) | 42 (1.3) | 77 (0.8) | <0.001c,e, 0.15d |
| Pulmonary Embolism | 6 (0.3) | 16 (0.2) | 10 (0.3) | 19 (0.2) | 0.44c, 0.91d, 0.42e |
| Other Comorbid Conditions | |||||
| Diabetes | 2888 (57.1) | 3373 (22.8) | 1576 (22.5) | 4397 (20.5) | <0.001c,d,e |
| Respiratory failure on ventilator | 231 (4.6) | 566 (3.8) | 400 (5.7) | 753 (3.5) | 0.02c, 0.005d, <0.001e |
| Renal Failure requiring RRT | 681 (13.5) | 1465 (9.9) | 1000 (14.3) | 1708 (8.0) | <0.001c,e, 0.20d |
| Renal Impairmentb | 2887 (57.2) | 5660 (38.2) | 3202 (45.9) | 7022 (32.7) | <0.001c,d,e |
| Recipient Complications of ESLD | |||||
| Ascites at transplant | 4378 (87.6) | 11933 (81.5) | 6221 (89.9) | 15659 (73.9) | <0.001c,d,e |
| SBP | 149 (7.8) | 600 (8.3) | 359 (10.8) | 653 (7.0) | 0.48c, <0.001d, 0.19e |
| Encephalopathy | 3811 (76.0) | 10460 (71.1) | 5608 (80.8) | 13003 (61.1) | <0.001c,d,e |
| Portal Vein Thrombosis | 551 (11.0) | 940 (6.4) | 536 (7.7) | 1504 (7.1) | <0.001c,d,e |
| TIPS | 655 (13.1) | 1436 (9.8) | 1019 (14.7) | 1948 (9.2) | <0.001c,e, 0.01d |
| Variceal Bleed | 146 (7.8) | 353 (4.9) | 239 (7.2) | 558 (6.0) | <0.001c, 0.48d, 0.005e |
| Functional status at transplant | |||||
| Independent | 2081 (45.3) | 6859 (51.9) | 2790 (44.6) | 10240 (52.9) | |
| Partially dependent | 1227 (26.7) | 3267 (24.7) | 1577 (25.2) | 4676 (24.2) | <0.001c,e, 0.02d |
| Totally dependent | 1282 (27.9) | 3087 (23.4) | 1894 (30.2) | 4435 (22.9) | |
| Recipient length of stay | 17.8 ± 23.0 | 15.7 ± 20.2 | 17.4 ± 21.7 | 15.2 ± 21.6 | <0.001c,e, 0.46d |
| Donor Factors | |||||
| Age | 43.4 ± 17.5 | 40.4 ± 16.0 | 42.7 ± 17.6 | 41.3 ± 17.2 | <0.001c,e, 0.02d |
| BMI (kg/m2) | 27.5 ± 6.3 | 26.8 ± 6.3 | 27.2 ± 6.0 | 26.7 ± 5.9 | <0.001c,e, 0.06d |
| Donation after Cardiac Death | 487 (9.6) | 1487 (10.0) | 748 (10.7) | 1974 (9.2) | 0.41c, 0.06d, 0.33e |
| Living Donor | 190 (3.8) | 558 (3.8) | 202 (2.9) | 1159 (5.4) | 0.98c, 0.008d, <0.001e |
| Graft cold ischemia time, hours | 7.14 ± 3.73 | 7.06 ± 3.65 | 7.15 ± 3.37 | 6.99 ± 3.62 | 0.20c, 0.91d, 0.02e |
| Recipient Immunoprophylaxis | |||||
| Calcineurin Inhibitor | 4669 (92.3) | 13975 (94.3) | 6559 (93.7) | 20247 (94.2) | <0.001c,e, 0.003d |
| Steroids | 4030 (79.7) | 11605 (78.3) | 5630 (80.5) | 17659 (82.2) | 0.04c, 0.30d, <0.001e |
a
Other=drug-induced, autoimmune, other viral hepatitis, cholestatic, metabolic
b
eGFR ≤ 60 mL/min/1.73 m2
c
NASH vs. HCV
d
NASH vs. alcohol
e
NASH vs. other
Values are expressed as number (%) or mean ± standard deviation
Abbreviations: NASH, nonalcoholic steatohepatitis; No, number; MELD, model for end-stage liver disease; BMI, body mass index; INR, international normalized ratio; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; RRT, renal replacement therapy; ESLD, end-stage liver disease; SBP, spontaneous bacterial peritonitis; TIPS, transjugular intrahepatic portosystemic shut