Abstract
Background
Over the last decades relevant epidemiological changes of liver diseases have occurred,
together with greatly improved treatment opportunities.
Aim
To investigate how the indications for elective adult liver transplantation and the
underlying disease etiologies have evolved in Italy.
Methods
We recruited from the National Transplant Registry a cohort comprising 17,317 adults
patients waitlisted for primary liver transplantation from January-2004 to December-2020.
Patients were divided into three Eras:1(2004–2011),2(2012–2014) and 3(2015–2020).
Results
Waitlistings for cirrhosis decreased from 65.9% in Era 1 to 46.1% in Era 3, while
those for HCC increased from 28.7% to 48.7%. Comparing Eras 1 and 3, waitlistings
for HCV-related cirrhosis decreased from 35.9% to 12.1%, yet those for HCV-related
HCC increased from 8.5% to 26.7%. Waitlistings for HBV-related cirrhosis remained
almost unchanged (13.2% and 12.4%), while those for HBV-related HCC increased from
4.0% to 11.6%. ALD-related cirrhosis decreased from 16.9% to 12.9% while ALD-related
HCC increased from 1.9% to 3.9%.
Conclusions
A sharp increase in liver transplant waitlisting for HCC and a concomitant decrease
of waitlisting for cirrhosis have occurred In Italy. Despite HCV infection has noticeably
decreased, still remains the primary etiology of waitlisting for HCC, while ALD and
HBV represent the main causes for cirrhosis.
Keywords
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Article info
Publication history
Published online: September 09, 2022
Accepted:
August 20,
2022
Received:
March 2,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- Waiting list trends for liver transplantation in Italy: A snapshot from the futureDigestive and Liver DiseaseVol. 54Issue 12
- PreviewIn recent years, significant changes have been observed in the field of liver transplantation (LT). On one side, the introduction of direct-acting antivirals (DAA) has modified the impact of HCV, mainly in areas like Italy, where the virus was endemic [1]. On the other side, a growing number of patients with metabolic dysfunction-associated fatty liver disease (MAFLD) has been reported, mainly in countries with a high prevalence of obesity [2]. Nevertheless, Italy is also experiencing an increase in this pathology [3].
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