ArticleHepatology communications2026
Clinical outcomes in MetALD compared with ALD in patients referred for liver transplant evaluation.
Article in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- From NAFLD to MASLD and MetALD: Conceptual Shifts in Metabolic Liver Disease and Their Implications for Mexico.Medicina (Kaunas, Lithuania) · 2026Review
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13 authors.
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Abstract
backgroundIn patients with steatotic liver disease, metabolic dysfunction and alcohol-associated liver disease (MetALD) is a recently defined entity combining metabolic syndrome and moderate-to-high alcohol consumption. Its prognosis and outcomes compared with alcohol-associated liver disease (ALD) remain underexplored. The aim of the study was to assess liver recompensation (LR) between the 2 groups in patients with decompensated liver disease referred for liver transplant (LT) evaluation.
methodsWe conducted a retrospective cohort study of 194 patients with decompensated liver disease, diagnosed as MetALD or ALD, and referred for LT evaluation between October 2021 and August 2023 at a single U.S. transplant center, and compared the outcomes between the 2 groups. The diagnoses of MetALD and ALD were based on the Delphi consensus definitions.
resultsOf the 194 patients, 135 (70%) had ALD and 59 (30%) had MetALD. Baseline characteristics showed significantly higher BMI (31 vs. 28 kg/m2, p=0.001), chronic kidney disease (32% vs. 17%, p=0.025), and lower Karnofsky scores (51 vs. 62, p=0.014) in the MetALD group. While no statistical difference was found in listing and LT rates between groups, LR occurred significantly less in MetALD compared with ALD (3% vs. 18%, p=0.006). On multivariable analysis, MetALD independently predicted lower LR (HR 0.21, 95% CI: 0.05-0.91). Hypertension (HR 0.38, 95% CI: 0.16-0.89) and increasing BMI (HR 0.91, 95% CI: 0.84-0.99) were also significantly associated with lower LR. While overall mortality was higher in the MetALD group (42% vs. 26%, p=0.029), MetALD was not an independent mortality predictor after adjustment.
conclusionsCompared with ALD, MetALD is associated with significantly lower LR in patients with decompensated liver diseases referred for LT evaluation.
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