Diverging Three-Year Survival Outcomes Among Contemporary ALD and MASH Liver Transplant Recipients.

Machicao, Maria Fernanda; Shi, Michael Auburn; Albahra, Ramsey; Han, Jeong; Lee, Tzu-Hao; Hernaez, Ruben; El-Serag, Hashem B; Kanwal, Fasiha et al. · Am J Gastroenterol · 2026

retrospective_cohort · Level III

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Abstract

We compared temporal trends in three-year survival trends for patients who underwent liver transplantation (LT) for ALD and MASH. Utilizing the UNOS registry, we examined three-year post-LT survival, stratified by etiology and year of LT, using Kaplan-Meier analysis with log-rank testing. Three-year survival was similar for ALD and MASH pre-COVID (88.7% vs. 88.5%, p=0.860) but diverged during COVID, with ALD showing higher survival (90.3% vs. 86.9%, p<0.001), particularly among White and Hispanic recipients. ALD recipients show excellent and improving survival, while MASH recipients' declining survival highlights the need for better risk stratification and management.