Steatotic liver disease is the dominant indication for liver transplantation in both Europe and the United States: Trends and outcomes in the past 2 decades

Regional differences in liver transplantation (LT) may exist. We described liver transplant populations in the US and European transplant centers over 2 decades. Data from 2 large LT registries: the US Scientific Registry of Transplant Recipients (SRTR) and the European Liver Transplant Registry (ELTR), years 2000-2022, were compared. There were 109,048 recipients of transplant from ELTR (30 countries), 128,765 from SRTR, and a higher proportion of HCC in ELTR (29% vs. 20%). Chronic hepatitis B (9% vs. 3%) and alcohol-associated liver disease (ALD) (30% vs. 23%) occurred more frequently among European recipients of transplant; chronic hepatitis C (18% vs. 27%) and NASH/metabolic dysfunction-associated steatohepatitis (MASH) (7% vs. 19%) for the United States (all p 1.0, p <0.01), similar between ELTR and SRTR, in patients without and with HCC. ALD and NASH/MASH are now leading indications for liver transplantation in 2 large global regions.