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Gastroenterology and Hepatology

Association of COVID-19 With New Waiting List Registrations and Liver Transplantation for Alcoholic Hepatitis in the United States

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Network Open

Published Online: October 26, 2021

Research Letter

Article Information and Disclosures

Maia S. Anderson, MD^1,2;

Valeria S. M. Valbuena, MD^1,2,3;

Craig S. Brown, MD, MSc^1,2;

Seth A. Waits, MD¹;

Christopher J. Sonnenday, MD, MHS^1,2;

Michael Englesbe, MD¹;

Jessica L. Mellinger, MD, MSc^2,4

Author Affiliations

¹Department of Surgery, University of Michigan, Ann Arbor, Michigan
²Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
³National Clinician Scholars Program, University of Michigan, Ann Arbor, Michigan
⁴Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan

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Alcohol consumption has substantially increased during the COVID-19 pandemic¹; however, the impact on the already increasing burden of alcohol-associated liver disease (ALD) is unknown.² We examined national changes in waiting list registration and liver transplantation for ALD and the association with alcohol sales during the COVID-19 pandemic. We hypothesized that waiting list registrations and deceased donor liver transplants (DDLTs) for alcoholic hepatitis (AH), which can develop after a short period of alcohol misuse, would disproportionately rise.

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Article Information

Accepted for Publication: August 21, 2021.

Published: October 26, 2021. doi:10.1001/jamanetworkopen.2021.31132

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Anderson MS et al. JAMA Network Open.

Corresponding Author: Jessica L. Mellinger, MD, MSc, Division of Gastroenterology and Hepatology, University of Michigan, 1500 E Medical Center Dr, 3912 Taubman Center, SPC 5362, Ann Arbor, MI 48109 (jmelling@med.umich.edu).

Author Contributions: Dr Mellinger had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Anderson, Valbuena, Brown, Waits, Mellinger.

Drafting of the manuscript: Anderson, Valbuena, Brown, Waits, Mellinger.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Anderson, Valbuena, Brown.

Administrative, technical, or material support: Valbuena, Sonnenday, Englesbe.

Supervision: Brown, Englesbe, Mellinger.

Conflict of Interest Disclosures: Dr Anderson reported receiving grants from the National Institute on Aging. Dr Valbuena reported receiving grants from the Institute for Healthcare Policy and Innovation Clinician Scholars Program and the National Institutes of Health. Dr Brown reported receiving grants from the Ruth L. Kirschstein Postdoctoral Research Fellowship Award administered by the National Institute on Drug Abuse. Dr Englesbe reported receiving grants from the Michigan Department of Health and Human Services and the National Institute on Drug Abuse and salary support from Blue Cross Blue Shield of Michigan. Dr Mellinger reported receiving grants from the National Institute on Alcohol Abuse and Alcoholism Career Development Award. No other disclosures were reported.

Funding/Support: This work was supported in part by contract No. HHSH250-2019-00001C from the Health Resources and Services Administration.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.

References

Pollard MS , Tucker JS , Green HD Jr . Changes in adult alcohol use and consequences during the COVID-19 pandemic in the US. JAMA Netw Open. 2020;3(9):e2022942. doi:10.1001/jamanetworkopen.2020.22942 PubMed Google Scholar

Lee BP , Vittinghoff E , Dodge JL , Cullaro G , Terrault NA . National trends and long-term outcomes of liver transplant for alcohol-associated liver disease in the United States. JAMA Intern Med. 2019;179(3):340-348. doi:10.1001/jamainternmed.2018.6536 PubMed Google Scholar Crossref

Harvey AC . Forecasting, Structural Time Series Models and the Kalman Filter. Cambridge University Press; 1989.

US Census Bureau. Monthly Retail Trade Services Report. Accessed September 23, 2021. https://www.census.gov/retail/index.html

Strauss AT , Boyarsky BJ , Garonzik-Wang JM , et al. Liver transplantation in the United States during the COVID-19 pandemic: national and center-level responses. Am J Transplant. 2021;21(5):1838-1847. doi:10.1111/ajt.16373 PubMed Google Scholar Crossref

Mathurin P , Moreno C , Samuel D , et al. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med. 2011;365(19):1790-1800. doi:10.1056/NEJMoa1105703 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.