Liver transplantation in Australia and New Zealand

McCaughan, Geoffrey W.; Munn, Stephen

doi:10.1002/lt.24446

Cited by 42 publications

(32 citation statements)

References 16 publications

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“…Median survival in adult recipients is approximately 20 years, and more than 70% of paediatric recipients are alive 20 years after transplantation. 370 According to the Australian Institute of Health and Welfare, in 2016 the second most common reason for hospital separations (ie, a hospital stay that results in change of the type of care) was alcohol-related liver disease.…”

Section: The Lancet Gastroenterology and Hepatology Commissionmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

412

303

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The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birthdose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region. 168 www.thelancet.com/gastrohep Vol 5 February 2020The Lancet Gastroenterology & Hepatology Commission accounted for 108 276 (8·2%) of the total liver-related deaths in the region in 2015, compared with 929 (1·2%) of 72 437 in the USA and 4032 (0·3%) of 197 179 in Europe. Deaths in the Asia-Pacific region represented three-quarters of the global total number of deaths due to acute viral hepatitis. In 2015, the region accounted for three-quarters of the global total number of deaths related to acute HBV, almost two-thirds of those due to acute hepatitis A infection, and almost 80% of those due to acute hepatitis E infection. Of all deaths du...

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Section: The Lancet Gastroenterology and Hepatology Commissionmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

412

303

View full text Add to dashboard Cite

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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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“…Up to 50% of ALD patients return to drinking after transplantation, and probably 20% return to harmful drinking, consistent with the range of recovery rates quoted in the addiction literature of between 30 and 70% . Heavy drinking appears to impact at the very least on the viability of allografts and perhaps on patient survival, so it seems reasonable that those with ongoing substance abuse are excluded . But critically, the overall survival of ALD patients after liver transplantation is reported to be at least as good as the survival of patients with hepatic disease of other aetiologies .…”

Section: Casementioning

confidence: 99%