SUNY Upstate Medical University, New York Syracuse, New York
Azhar Hussain, MD1, Kaleem Ullah, MBBS, FCPS2, Abdul Wahab Dogar, MBBS, FCPS2, Shams Ud-Din, MBBS, FCPS2, Abu Hurairah, MD3 1SUNY Upstate Medical University, New York, Syracuse, NY; 2Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan; 3AdventHealth, Orlando, FL
Introduction: Liver transplantation plays a pivotal role in the cure of liver disease and is considered a recommended treatment for patients with end-stage liver disease including hepatocellular carcinoma. The purpose of this study was to conduct an in-depth analysis of different etiology of liver disease and their indications of liver transplantation and also to observe the variations in various provinces of the country.
Methods: This study includes a retrospective analysis of the etiological spectrum of liver diseases as an indication of liver transplantation performed during the last five years at Pir Abdul Qadir Shah Jelani Institute of Medical Sciences Hospital from 2018-2022. The indications and their relations with various demographics parameters were done.
Results: A total of 600 liver transplants were performed during this period. Most patients were between the ages of 31-50 years (range 10-70 years). Males and females were equal. 75% donors were females with majority of them being daughters and sisters. Three hundred fifty-four (68.3%) patients had chronic hepatitis. Of these 86% had hepatitis C, 10.7% hepatitis B and 3.1% had both hepatitis B and C. Of 41(7.9%) hepatocellular carcinomas, 29.3% were due to hepatitis C and 14% were due to hepatitis B virus infection. Etiology was not known in 53% of cases of HCC. Other categories included chronic hepatitis with early cirrhosis (4.8%), cirrhosis (3.1%), adenocarcinoma (4.6%), and other miscellaneous conditions.
Discussion: In this study, we analyzed and highlighted the frequency of LT indications among LT recipients in a single center in Pakistan over 5 years. According to our center's data, 354/600 (68.3%) of patients had chronic hepatitis. Of these 86% had hepatitis C, 10.7% had hepatitis B and 3.1% had both hepatitis B and C. Also, before the use of DAAs, CLD, and HCC was leading factors of LT in the USA and Western world, but recent studies highlighted the increasing incidence of non-alcoholic fatty liver disease (NAFLD) and alcohol-associated liver disease added to U.S. liver transplant waiting list. The 2018 Annual Report of the European LT Registry noted a sharp decline in Viral Hepatitis related indications over the last 50 years, and the report projected that NASH will be the leading indication for LT in Europe within the next decade, but our data indicated that situation remains same in Pakistan. This study concludes that Pakistan needs a well planned hepatitis elimination program to curb disease burden and eventually need for LDLT.
Disclosures:
Azhar Hussain indicated no relevant financial relationships.
Kaleem Ullah indicated no relevant financial relationships.
Abdul Wahab Dogar indicated no relevant financial relationships.
Shams Ud-Din indicated no relevant financial relationships.
Abu Hurairah indicated no relevant financial relationships.
Azhar Hussain, MD1, Kaleem Ullah, MBBS, FCPS2, Abdul Wahab Dogar, MBBS, FCPS2, Shams Ud-Din, MBBS, FCPS2, Abu Hurairah, MD3. P3844 - The Etiological Trend of Liver Transplant Indication in Pakistan and Its Differences from West, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.