HCC-based transplants straining donor pool, speaker says

  • November 20, 2013

WASHINGTON — The increase in the number of hepatocellular carcinoma patients in the United States being wait-listed for transplant is leading to a greater incidence of wait-listing for all individuals with hepatitis C, a speaker said here.

“The demand for liver transplantation for hepatocellular carcinoma is likely going to continue to rise and further strain our already limited donor pool,” Jennifer A. Flemming, MD, FRCP(C), MAS, of the University of California at San Francisco, said at The Liver Meeting. “This could influence HCC listing policy over the next decade and may push the transplant community to consider nontransplant alternatives [for HCC patients].”

Jennifer A. Flemming, MD, FRCP(C), MAS

Jennifer A. Flemming

Researchers analyzed data from 20,325 adult patients listed for liver transplantation secondary to HCV on the Scientific Registry for Transplant Recipients database between 2003 and 2010. Patients were considered to be wait-listed for end-stage liver disease (ESLD) if their MELD score was 15 or greater at the initial wait-list date. Patients were considered wait-listed for HCC if they were listed with HCC or received a MELD exception for HCC within 180 days of entering the wait list.

The total number of listed individuals rose from 2,074 in 2003 to 3,053 in 2010. Of those, 1,451 were listed for ESLD in 2003 and 1,674 were listed in 2010. The number listed for HCC, however, more than doubled from 623 in 2003 to 1,379 in 2010.

Adjusted for age and gender, the overall rate of listing for HCV increased from 6.9 patients per 100,000 in 2003 to 10.2 per 100,000 in 2010 (P<.001).

“Importantly, this increase was entirely attributable to HCC, which, on average, rose by 12% per year,” researchers concluded.

Disclosure: Flemming reports no relevant financial disclosures.

For more information:

Flemming JA. #12: Increased Rates of Liver Transplant Wait-Listing for Hepatocellular Carcinoma in Individuals with Hepatitis C from 2003 – 2010 in the United States. Presented at: The Liver Meeting 2013; Nov. 1-5, Washington.