Su1013 Prevalence and Outcomes of Incidental Hepatocellular Carcinoma Among Liver Transplant Recipients: A Study From United Nation of Organ Sharing (UNOS) Database

Abstract

respectively), about 5.8% (N=2319) received SLK (6, 9, and 5% in groups I-III respectively). Of LTA, 22%, 14%, and 64% were performed for group I-III respectively. Similar respective figures of all SLK were 23, 20, and 57% respectively (Figure). Frequency of SLK increased from about 4% in 2002 to about 7% in 2011. Trends for group I-III were 4 to 5.8%, 4 to 10%, and 4 to 8% respectively. SLK for NASH+CC (group II, n=477) compared to1842 non-NASH SLK (group II+III) were older, more likely to be females, diabetics, andCaucasians, and have higher body mass index. Five year respective outcomes after SLK comparing group I-III were 78 vs. 76 vs. 66% for liver graft, 79 vs. 72 vs. 65% for kidney graft, and 81 vs. 77 vs. 69% for patient survival, Log Rank P<0.0001 for all. Comparing groups I and II, outcomes were similar for liver graft (P=0.29) and patient survival (p=0.14) but worse for group II on kidney graft (P=0.01). Diabetics compared to non-diabetics had worse five year kidney survival for non-NASH SLK (67 vs. 71%, P=0.044). Similar respective figures among group II were 69 vs. 78%, P=0.017. Patients receiving SLK for NASH or CC (group II) were 29%more likely to lose kidney graft [1.29 (1.002-1.67]) compared to non-NASH transplants after controlling for recipient characteristics and kidney donor risk index. Other strong predictors were black race [1.32 (1.06-1.63] and dialysis [1.26 (1.07-1.49)]. Conclusion: Frequency of SLK transplants is increasing among NASH patients requiring liver transplantation. SLK recipients for NASH have worse renal outcomes independent of associated diabetes. Studies are needed to examine mechanisms of renal pathology in NASH and to develop strategies to improve renal outcomes in NASH patients receiving SLK.