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Diseases 2017, 5(4), 20; doi:10.3390/diseases5040020

Rising Rates of Hepatocellular Carcinoma Leading to Liver Transplantation in Baby Boomer Generation with Chronic Hepatitis C, Alcohol Liver Disease, and Nonalcoholic Steatohepatitis-Related Liver Disease

1
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305, USA
2
Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA 95128, USA
3
Division of Gastroenterology and Hepatology, University of California, Los Angeles, CA 90095, USA
4
Department of Medicine, California Pacific Medical Center, San Francisco, CA 94114, USA
5
Division of Gastroenterology and Hepatology, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
6
Department of Biostatistics, Brown University School of Public Health, Providence, RI 02912, USA
*
Author to whom correspondence should be addressed.
Received: 28 August 2017 / Revised: 24 September 2017 / Accepted: 25 September 2017 / Published: 26 September 2017
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Abstract

We aim to study the impact of the baby boomer (BB) generation, a birth-specific cohort (born 1945–1965) on hepatocellular carcinoma (HCC)-related liver transplantation (LT) in patients with chronic hepatitis C virus (HCV), alcoholic liver disease (ALD), and non-alcoholic steatohepatitis (NASH). We performed a retrospective analysis using the United Network for Organ Sharing (UNOS)/Organ Procurement Transplant Network (OPTN) database from 2003 to 2014 to compare HCC-related liver transplant surgery trends between two cohorts—the BB and non-BB—with a secondary diagnosis of HCV, ALD, or NASH. From 2003–2014, there were a total of 8313 liver transplant recipients for the indication of HCC secondary to HCV, ALD, or NASH. Of the total, 6658 (80.1%) HCC-related liver transplant recipients were BB. The number of liver transplant surgeries for the indication of HCC increased significantly in NASH (+1327%), HCV (+382%), and ALD (+286%) during the study period. The proportion of BB who underwent LT for HCC was the highest in HCV (84.7%), followed by NASH (70.3%) and ALD (64.7%). The recommendations for birth-cohort specific HCV screening stemmed from a greater understanding of the high prevalence of chronic HCV and HCV-related HCC within BB. The rising number of HCC-related LT among BB with ALD and NASH suggests the need for increased awareness and improved preventative screening/surveillance measures within NASH and ALD cohorts as well. View Full-Text
Keywords: baby boomer; hepatitis C virus; alcoholic liver disease; non-alcoholic steatohepatitis; liver transplantation baby boomer; hepatitis C virus; alcoholic liver disease; non-alcoholic steatohepatitis; liver transplantation
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Cholankeril, G.; Yoo, E.R.; Perumpail, R.B.; Liu, A.; Sandhu, J.S.; Nair, S.; Hu, M.; Ahmed, A. Rising Rates of Hepatocellular Carcinoma Leading to Liver Transplantation in Baby Boomer Generation with Chronic Hepatitis C, Alcohol Liver Disease, and Nonalcoholic Steatohepatitis-Related Liver Disease. Diseases 2017, 5, 20.

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