AUTHOR=Lamm Ryan , Altshuler Peter J. , Patel Keyur , Shaheen Osama , Amante Angel Paulo , Civan Jesse , Maley Warren , Frank Adam , Ramirez Carlo , Glorioso Jaime , Shah Ashesh , Dang Hien , Bodzin Adam S. 

TITLE=Reduced Rates of Post-Transplant Recurrent Hepatocellular Carcinoma in Non-Alcoholic Steatohepatitis: A Propensity Score Matched Analysis

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10175

DOI=10.3389/ti.2022.10175

ISSN=1432-2277

ABSTRACT=Main Problem: Non-alcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC) has become the second leading cause of HCC-related liver transplantation in the United States. This study investigated post-transplant recurrence and survival for patients transplanted for NASH-related HCC compared to non-NASH HCC etiologies. 
Methods: Retrospective review of the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network (OPTN) database identified 7,461 patients with HCC - 1,405 with underlying NASH and 6,086 with non-NASH underlying diseases. After propensity score matching (PSM) to account for patient- and tumor-related confounders 1,175 remained in each group. Primary outcomes assessed were recurrence rate and recurrence-free survival. 
Results: Recurrent malignancy at 5 years post-transplant was lower in NASH compared to non-NASH patients (5.80 vs. 9.41%, p=0.01). Recurrence-free survival, however, was similar at 5 years between groups. 
Conclusions: Patients with NASH-related HCC were less likely to have post-transplant recurrence than their non-NASH counterparts, although recurrence-free survival was similar at 5 years.