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

OBJECTIVES: We compared temporal trends in three-year survival trends for patients who underwent liver transplantation (LT) for ALD and MASH. METHODS: 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. RESULTS: 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. CONCLUSIONS: ALD recipients show excellent and improving survival, while MASH recipients' declining survival highlights the need for better risk stratification and management.