The increasing burden of potentially preventable liver disease among adult liver transplant recipients: A comparative analysis of liver transplant indication by era in Australia and New Zealand

Howell, Jessica; Balderson, Glenda A.; Hellard, Margaret; Gow, Paul J; Strasser, Simone I.; Stuart, Katherine; Wigg, Alan; Jeffrey, Gary P.; Gane, Edward; Angus, Peter W

doi:10.1111/jgh.13082

Cited by 14 publications

(18 citation statements)

References 69 publications

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“…Prior to the year 2000, there were no cases of liver transplantation recorded for NAFLD/NASH, although some may have been misclassified as cryptogenic cirrhosis. Since then, NASH has been increasing as an indication for transplantation in Australia and New Zealand, and in the period 2010–2014, NAFLD/NASH accounted for 6% of transplants in Australia . By 2015, NAFLD/NASH had risen to be the third commonest indication for listing for liver transplantation in Australia and New Zealand, accounting for 9% of listings behind hepatitis C infection and alcohol‐related liver disease…”

Section: Prevalence Of Non‐alcoholic Fatty Liver Disease In Australiamentioning

confidence: 99%

Burden of non‐alcoholic fatty liver disease in Australia

Mahady

Adams

2018

J of Gastro and Hepatol

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Non-alcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease in the Australian population, although precise estimates of prevalence are lacking. NAFLD may progress to liver fibrosis, cirrhosis, decompensated liver disease, and liver cancer and is becoming an increasingly common indication for liver transplantation in Australia and New Zealand. There is an extrahepatic burden of NAFLD extending beyond the liver, which is manifested by an increased risk of developing cardiovascular disease, diabetes, and chronic renal impairment, all of which are common causes of morbidity in the Australian population. Early recognition of those patients at high risk of developing advanced liver disease is essential in order to target those who will benefit from intensive lifestyle modification. In this review, we present data on the epidemiology of NAFLD within Australia, its associated health burden in terms of hepatic and extrahepatic complications, common clinical presentations, and indications for treatment. We also propose a research agenda that highlights knowledge needed to improve diagnosis and management specific to the Australian context.

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Section: Prevalence Of Non‐alcoholic Fatty Liver Disease In Australiamentioning

confidence: 99%

Burden of non‐alcoholic fatty liver disease in Australia

Mahady

Adams

2018

J of Gastro and Hepatol

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“…Non-alcoholic fatty liver disease (NAFLD) is the most common liver condition in the Western world and an increasingly common indication for liver transplantation 1, 2 . It incorporates a spectrum of liver diseases characterized by abnormal accumulation of lipid (steatosis) arising in the absence of excess alcohol consumption.…”

Section: Introductionmentioning

confidence: 99%

Non-alcoholic fatty liver disease, vascular inflammation and insulin resistance are exacerbated by TRAIL deletion in mice

Cartland

Harith

Genner

et al. 2017

Sci Rep

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Non-alcoholic fatty liver disease (NAFLD) incorporates steatosis, non-alcoholic steato-hepatitis (NASH) and liver cirrhosis, associating with diabetes and cardiovascular disease (CVD). TNF-related apoptosis-inducing ligand (TRAIL) is protective of CVD. We aimed to determine whether TRAIL protects against insulin resistance, NAFLD and vascular injury. Twelve-week high fat diet (HFD)-fed Trail −/− mice had increased plasma cholesterol, insulin and glucose compared to wildtype. Insulin tolerance was impaired with TRAIL-deletion, with reduced p-Akt, GLUT4 expression and glucose uptake in skeletal muscle. Hepatic triglyceride content, inflammation and fibrosis were increased with TRAIL-deletion, with elevated expression of genes regulating lipogenesis and gluconeogenesis. Moreover, Trail −/− mice exhibited reduced aortic vasorelaxation, impaired insulin signaling, and >20-fold increased mRNA expression for IL-1β, IL-6, and TNF-α. In vitro, palmitate treatment of hepatocytes increased lipid accumulation, inflammation and fibrosis, with TRAIL mRNA significantly reduced. TRAIL administration inhibited palmitate-induced hepatocyte lipid uptake. Finally, patients with NASH had significantly reduced plasma TRAIL compared to control, simple steatosis or obese individuals. These findings suggest that TRAIL protects against insulin resistance, NAFLD and vascular inflammation. Increasing TRAIL levels may be an attractive therapeutic strategy, to reduce features of diabetes, as well as liver and vascular injury, so commonly observed in individuals with NAFLD.

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“…The number of deaths is expected to continue to increase over the coming decade as disease progresses in the currently infected population and the number of people with end‐stage liver disease grows . Consequently, hepatitis C and viral hepatitis are the leading causes of liver transplantation in North America and Europe, respectively, incurring a sizeable economic and public health burden …”

Section: The Global Burden Of Hepatitis C Virusmentioning

confidence: 99%

“…7,8 Consequently, hepatitis C and viral hepatitis are the leading causes of liver transplantation in North America and Europe, respectively, incurring a sizeable economic and public health burden. 7,[9][10][11][12]…”

Section: The G Lobal Burden Of Hepatitis C Virusmentioning

confidence: 99%

Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience

Goutzamanis

Doyle

Higgs

et al. 2018

Journal of Viral Hepatitis

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Summary Hepatitis C virus contributes to substantial and growing mortality and morbidity. Fortunately, the advent of highly effective interferon‐free direct‐acting antiviral (DAA) medications and new diagnostic tests has the potential to dramatically alter the epidemiologic trajectory of hepatitis C, particularly for “hard‐to‐reach” populations. Treatment advances and cure will also likely alter the individual experience of living with hepatitis C. However, it is not yet known in what capacity. This paper provides an overview of the population‐level impact of DAA treatment, highlighting the need to further our understanding of the impact of treatment on behaviour, health and wellbeing through lived experience and more sensitive patient‐reported outcome measures.

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The increasing burden of potentially preventable liver disease among adult liver transplant recipients: A comparative analysis of liver transplant indication by era in Australia and New Zealand

Cited by 14 publications

References 69 publications

Burden of non‐alcoholic fatty liver disease in Australia

Burden of non‐alcoholic fatty liver disease in Australia

Non-alcoholic fatty liver disease, vascular inflammation and insulin resistance are exacerbated by TRAIL deletion in mice

Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience

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