Increase Driven by Liver Cancer Development in Baby Boomers
New research reveals that the greatest demand for
liver transplantation due to hepatitis C (HCV)-related liver disease
occurs among Americans born between 1941 and 1960. Findings in the
December issue of Liver Transplantation,
a journal published by Wiley on behalf of the American Association for
the Study of Liver Diseases (AASLD), suggest that continuing increased
demand for transplantation is driven by the development of liver cancer
in baby boomers with HCV, but that the demand may decrease as patients
born in this time period continue to grow older.
HCV is the most common blood-borne infection and
cause of liver disease requiring transplantation in the U.S.,
chronically infecting more than one percent of Americans. Previous
studies show that among patients living with chronic HCV, 10% to 20%
will develop cirrhosis and up to 5% will progress to liver cancer
(hepatocellular carcinoma; HCC). Further evidence implicates HCV as the
primary risk factor for developing HCC in up to 47% of cases of
patients with HCC.
The peak U.S. HCV prevalence of 4% occurred in
those born in 1940 through 1965, who were 20 to 30 years of age during
1979 to 1989, when HCV infection risk was at its highest. As this
population ages, Davis et al. project that between 2000 and 2030
cirrhosis in patients with HCV will increase two-fold, from 472,000 to
879,000. Moreover, Wise et al. suggests HCV-related deaths will
increase in Americans 55 to 64 years of age by 2004.
“The dire projections in HCV complications spurred our
investigation of age-specific trends in liver transplantation demand,”
said lead author Dr. Scott Biggins with the University of Colorado
School of Medicine in Aurora, Colo. For the present study, researchers
identified all adult liver transplant candidates who were registered
with the Organ Procurement and Transplantation Network (OPTN) between
1995 and 2010. Patients were then classified with the diagnosis of HCV,
with or without HCC.
Results show there were 126,862 new candidates for first liver
transplant registered with OPTN, with 41% of these having HCV.
Candidates were categorized by birth year and found that the highest HCV
frequency (in decreasing order) were those born in 1951-1955,
1956-1960, 1946-1950, and 1941-1945. These four birth groups represent
81% of all new liver transplant registrants with HCV.
Furthermore, findings indicate that between 2000
and 2010 there was a four-fold increase in new transplant candidates
with HCV and HCC in the 1941 to 1960 birth cohorts. The authors
anticipate an increase in the proportion of new registrants, 60 years
and older, with HCV will have liver cancer.
“Over the coming decade the aging of those
infected with HCV will challenge the transplant community to reconsider
current treatment plans given the projected increase in liver
transplantation demand, particularly from patients with HCV and liver
cancer,” concludes Dr. Biggins. “With the aging of the population of
patients with HCV, many of these patients may not be healthy enough for
transplantation and the number of liver transplants in patients with HCV
This study was funded in part by grants from the
National Center for Research Resources, the National Institute of
Diabetes and Digestive and Kidney Diseases, and the Agency for
Healthcare Research and Quality.
This study is published in Liver Transplantation. Media wishing to receive a PDF of the article may contact firstname.lastname@example.org
Full citation: “Projected Future Increase in
Aging HCV-Infected Liver Transplant Candidates: A Potential Effect of
HCC.” Scott W. Biggins, Kiran M. Bambha, Norah A. Terrault, John
Inadomi, Stephen Shiboski, Jennifer L. Dodge, Jane Gralla, Hugo R. Rosen
and John P. Roberts. Liver Transplantation; (DOI: 10.1002/lt.23551) Print Issue Date: December, 2012.
Author Contact: Media wishing to speak with Dr. Biggins may contact Dan Meyers with the University of Colorado School of Medicine at email@example.com or at +1 303-724-5377
About the Journal:
Liver Transplantation is published by Wiley on behalf of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.
Since the first application of liver transplantation in a clinical
situation was reported more than twenty years ago, there has been a
great deal of growth in this field and more is anticipated. As an
official publication of the AASLD and the ILTS,
Liver Transplantation delivers current, peer-reviewed articles on
surgical techniques, clinical investigations and drug research — the
information necessary to keep abreast of this evolving specialty. For
more information, please visit http://wileyonlinelibrary.com/journal/livertransplantation
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