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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
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Department of Medicine, California Pacific Medical Center, San Francisco, CA 94114, USA
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Division of Gastroenterology and Hepatology, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
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Department of Biostatistics, Brown University School of Public Health, Providence, RI 02912, USA
*
Author to whom correspondence should be addressed.
Diseases 2017, 5(4), 20; https://doi.org/10.3390/diseases5040020
Received: 28 August 2017 / Revised: 24 September 2017 / Accepted: 25 September 2017 / Published: 26 September 2017
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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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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