ArticleHepatology (Baltimore, Md.)2025
Waitlisting and liver transplantation for MetALD in the United States: An analysis of the UNOS national registry.
Article in Hepatology (Baltimore, Md.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Distinct Laboratory and Clinical Features of Metabolic and Alcohol-Related Liver Disease (MetALD): A Systematic Review and Meta-Analysis.Current obesity reports · 2026Pooled it
- The global burden of metabolic and alcohol-associated liver disease (MetALD).Hepatology communications · 2026Review
- Steatotic liver disease in Latin America: current views and perspectives.Nature reviews. Gastroenterology & hepatology · 2026Review
- [Research progress on the applicability of diagnostic criteria for metabolic and alcohol-related liver disease in patients with cirrhosis and after liver transplantation].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Global epidemiology of metabolic and alcohol-associated liver disease: risk factors, natural history and clinical implications.Nature reviews. Gastroenterology & hepatology · 2026Review
- Global Longitudinal Assessment of MASLD Using Magnetic Resonance Elastography (GOLDMINE): A Multi-Center, International Prospective Cohort Study of Imaging Biomarkers in MASLD Clinical Outcomes.Alimentary pharmacology & therapeutics · 2026Article
- Liver donor macrosteatosis is associated with adverse long-term outcomes exclusively in metabolic dysfunction-associated steatotic liver disease recipients: a U.S. transplant registry analysis over the last decade.Hepatobiliary surgery and nutrition · 2026Article
- Steatotic Liver Disease has Surpassed Viral Hepatitis as the Leading Cause of Cirrhosis in the US Veterans Health System.The American journal of gastroenterology · 2026Article
- Trends in Concurrent Psychiatric Comorbidities in Alcohol-Associated Liver Disease: A Nationwide Study from 2015-2023.Digestive diseases and sciences · 2026Article
- Impact of acuity circles policy on ABO blood type-related waitlist outcomes in liver transplantation.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- MetALD: decoding the evolution of steatotic liver disease nomenclature and implications for clinical practice and beyond.Gastroenterology report · 2026Review
- Clinical outcomes in MetALD compared with ALD in patients referred for liver transplant evaluation.Hepatology communications · 2026Article
- Steatotic liver disease and liver transplantation: Candidate selection and post-transplant management.JHEP reports : innovation in hepatology · 2026Review
- Beyond diabetes and obesity: GLP-1 receptor agonists as multifunctional therapeutics across the steatotic liver disease spectrum.Frontiers in pharmacology · 2026Review
- Alcohol-related liver disease and access to liver transplantation: where we stand and where we should go.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Oxidative Stress in Liver Metabolic Dysfunction and Diseases, with a Focus on Hepatogenic Diabetes: Effect of Alcohol Consumption.Antioxidants (Basel, Switzerland) · 2025Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Mechanisms, Clinical Implications and Therapeutic Advances.Endocrinology, diabetes & metabolism · 2025Review
- MELD 3.i: A Bayesian framework for updating the model for end-stage liver disease score.JHEP reports : innovation in hepatology · 2025Article
- MetALD: New Perspectives on an Old Overlooked Disease.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Trends in candidate hepatitis C virus nucleic acid amplification test (NAT)+ listing and associated impacts on liver transplantation waitlist outcomes.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
BACKGROUND AND
aimsThe new steatotic liver disease (SLD) nomenclature introduced metabolic and alcohol-associated liver disease (MetALD), describing the intersection of metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease. Waitlisting and liver transplantation for MetALD are not well defined. We aimed to develop and validate an algorithm for identifying SLD phenotypes and assessing trends in waitlisting and transplant outcomes. APPROACH AND
resultsWe conducted a retrospective cohort study using the United Network for Organ Sharing registry, supplemented with detailed single-center data. We developed 5 candidate algorithms for SLD classification and calculated their diagnostic performance. Trends in waitlist registrations and transplants were estimated, and competing risk analyses and Cox regression models were conducted to assess waitlist removal and posttransplant outcomes among SLD phenotypes. The best-performing algorithm demonstrated substantial agreement (weighted kappa, 0.62) for SLD phenotypes, with acceptable sensitivity (73%) for MetALD. Between 2002 and 2022, waitlist registrations and transplants for MetALD increased 2.9-fold and 3.3-fold, respectively. Since 2013, there has been a significant increase in the absolute number of waitlist registrations (122 per year; 95% CI, 111-133) and transplants (107 per year; 95% CI, 94-120) for MetALD. Patients with MetALD experienced higher waitlist removal (adjusted subdistribution hazard ratio, 1.10; 95% CI, 1.03-1.17), all-cause mortality (adjusted hazard ratio, 1.13; 95% CI, 1.03-1.23), and graft failure (adjusted hazard ratio, 1.12; 95% CI, 1.03-1.21) than those with alcohol-associated liver disease.
conclusionsWe developed and validated an algorithm for identifying SLD phenotypes in UNOS. MetALD is the third leading etiology among those waitlisted and underwent transplantation, exhibiting worse pretransplantation and posttransplantation outcomes compared to alcohol-associated liver disease. Identifying and addressing factors determining poor outcomes is crucial in this patient population.
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