P1220 - Trends and Outcomes of Liver Transplant in Patients with Alcohol-Associated Liver Cirrhosis Versus Non-Alcohol Associated Liver Cirrhosis: A Nationwide Study

Sajana Poudel, MD¹, Manoj Ghimire, MD², Ayusha Poudel, MD¹, Karun Shrestha, MD², Calvin Ghimire, MD³, Wendy Tatiana Graazon. Siatoya, MD², Kalpana Ghimire, MD², Prakriti Subedi, MD^4
1John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ²St. Barnabas Hospital, Bronx, NY; ³McLaren Flint Hospital, Flint, MI; ⁴St. Barnabas Hospital, New York, NY

Introduction: A liver transplant (LT) is a lifesaving procedure for end-stage liver disease. Decompensated cirrhosis, especially alcohol-associated liver cirrhosis (ALC), is a leading cause of LT. ALC patients face unique challenges due to chronic alcohol use affecting multiple body systems, often posing problems before and after LT. Early diagnosis and management of these issues are crucial. Our study compared LT outcomes in patients with ALC and non-alcohol-associated liver cirrhosis (NALC).

Methods: We conducted a retrospective observational study using the National Inpatient Sample database from 2016 to 2021. Adult patients (age >17 years) who underwent LT were included. We compared demographics, hospital outcomes, and complications between ALC and NALC. Additionally, we analyzed the trend of liver transplants among these two groups during the study period.

Results: During the study period, 45,460 liver transplants were performed: 35.9% for ALC and 43.5% for NALC. ALC patients were older (mean age 57.4 vs 53.7 years, p< 0.001) and more likely to be females (40.68% vs 25.46%, p< 0.001). NALC was more common in white patients (72.4% vs 66.6%, p< 0.001), while ALC was higher among black (8.5% vs 4.65%, p< 0.001) and Asian (5.1% vs 1.7%, p< 0.001). During the study period, there was an increasing trend of LT among ALC, while the trend remained constant for NALC. ALC patients had higher rates of comorbidities: rheumatoid disease (1.8% vs 0.8%, p< 0.001), diabetes (24.3% vs. 15.5%, p< 0.001), and diabetes with complications (16.5% vs 10.1%, p< 0.001). ALC patients had a higher rate of LT failure (1.92% vs. 0.75%, p< 0.001), but rates of rejection, infection, and mortality were similar among the groups. NALC patients had longer hospital stays (19.7 vs. 16.9 days, p< 0.001) and higher costs ($614,043 vs. $553,503, p< 0.001).

Discussion: Our study reveals key differences between LT in ALC vs NALC patients. ALC patients were older, more often female, and more likely to be Black or Asian. They had higher rates of comorbidities, likely contributing to increased transplant failure despite similar rejection and infection rates. Mortality rates were similar, but NALC patients had longer hospital stays and higher costs, indicating more complex care needs. The rising trend in ALC transplants highlights the growing burden of ALC. These findings emphasize the importance of specialized pre-LT screening and tailored post-transplant care for ALC patients to improve LT outcomes.



Disclosures:


Sajana Poudel, MD¹, Manoj Ghimire, MD², Ayusha Poudel, MD¹, Karun Shrestha, MD², Calvin Ghimire, MD³, Wendy Tatiana Graazon. Siatoya, MD², Kalpana Ghimire, MD², Prakriti Subedi, MD⁴. P1220 - Trends and Outcomes of Liver Transplant in Patients with Alcohol-Associated Liver Cirrhosis Versus Non-Alcohol Associated Liver Cirrhosis: A Nationwide Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.