Hepatitis C remains leading indication for listings and receipt of liver transplantation for hepatocellular carcinoma

Dig Liver Dis. 2020 Jan;52(1):98-101. doi: 10.1016/j.dld.2019.08.022. Epub 2019 Sep 30.


Background and aims: With the availability of direct acting antivirals (DAA) for hepatitis C virus (HCV) infection, alcoholic liver disease (ALD) has evolved as the leading indication for listing and receipt of liver transplantation (LT) followed by non-alcoholic steatohepatitis and HCV infection. However, data are limited on etiology specific trends on listings and need for LT for hepatocellular carcinoma (HCC).

Methods: We analyzed UNOS database to examine etiology specific listings and receipt of LT for patients with and without HCC. Listings and receipt of LT in the pre-DAA (2007-2012) era were compared to the DAA (2013-2018) era.

Results: The analysis shows that among patients without HCV, there is a decreasing trend on the proportion of patients listed and transplanted for HCV, with simultaneous increase on listings and LT for NASH and ALD. Specifically for listings and transplants for HCC, the leading etiology remains HCV infection followed by NASH and ALD. The analysis also showed that LT for AH contributes to about 20% of increase in listings and receipt of LT for ALD.

Keywords: HCC; HCV; OLT.

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / drug therapy
  • Carcinoma, Hepatocellular / surgery*
  • Carcinoma, Hepatocellular / virology
  • Graft Survival
  • Hepacivirus / drug effects
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Liver Diseases, Alcoholic / complications
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / surgery*
  • Liver Neoplasms / virology
  • Liver Transplantation / statistics & numerical data*
  • Liver Transplantation / trends
  • Non-alcoholic Fatty Liver Disease / complications
  • Registries
  • Tissue and Organ Procurement
  • Treatment Outcome
  • United States
  • Waiting Lists


  • Antiviral Agents