{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:52:33Z","timestamp":1791647553267,"version":"4.3.4"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Drug\u2010induced liver injury (DILI) due to medications and herbal and dietary supplements (HDSs) is a major cause of acute liver injury leading to liver transplantation (LT). This study used United Network for Organ Sharing LT data to analyze severe HDS\u2010induced acute liver injury in the United States. By convention, patients with acute DILI are listed as \u201cAcute Hepatic Necrosis\u201d (AHN) under the subheading \u201cAHN: Drug Other Specify.\u201d All patients waitlisted from 1994 to 2020 were divided into 3 subgroups: \u201cHDS DILI,\u201d \u201cNon\u2010HDS DILI,\u201d and \u201cAHN: unknown drug.\u201d Analyses were performed to identify epidemiologic differences between patients with HDS DILI and non\u2010HDS DILI. A subanalysis was performed for transplanted patients, including longitudinal changes. Of 1875 patients waitlisted for LT, 736 (39.2%) underwent LT. The proportion of Asian patients in the HDS DILI group was significantly higher compared with that in the non\u2010HDS DILI group (17.4% versus 3.8%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001). Excluding acetaminophen cases, the proportion of Black patients in the HDS DILI versus non\u2010HDS group was significantly lower (8.7% versus 25.3%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001). Waitlisted patients with HDS DILI were significantly older (median age, 38 years for HDS DILI versus 31 years for non\u2010HDS DILI; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.03). Lastly, the number of patients requiring LT due to HDS DILI increased significantly over time with more than 70% of cases occurring in the last 10\u00a0years (2010\u20102020) compared with the prior 15\u00a0years (1994\u20102009; <jats:italic toggle=\"yes\">P<\/jats:italic>\n                           <jats:sub>trend<\/jats:sub>\u00a0=\u00a00.001). Ethnicity may help in identifying the cause of severe acute DILI, a growing problem as more patients experiment with HDS.<\/jats:p>","DOI":"10.1002\/lt.26260","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T15:37:48Z","timestamp":1628523468000},"page":"188-199","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["Liver Transplantation for Acute Liver Injury in Asians Is More Likely Due to Herbal and Dietary Supplements"],"prefix":"10.1097","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-0249","authenticated-orcid":false,"given":"Varun","family":"Kesar","sequence":"first","affiliation":[{"name":"Division of Liver Diseases,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Channen","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umair","family":"Masood","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Grewal","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitzan C.","family":"Roth","sequence":"additional","affiliation":[{"name":"Division of Hepatology and Sandra Atlas Bass Center for Liver Diseases,Donald and Barbara School of Medicine at Hofstra\/Northwell,Long Island,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Odin","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"lt26260-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"947","DOI":"10.7326\/0003-4819-137-12-200212170-00007","article-title":"Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States","volume":"137","year":"2002","journal-title":"Ann Intern Med"},{"key":"lt26260-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.cgh.2013.07.030","article-title":"Herbs and liver injury: a clinical perspective","volume":"12","year":"2014","journal-title":"Clin Gastroenterol 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the United States: analysis of the United Network for Organ Sharing database","volume":"15","year":"2009","journal-title":"Liver Transpl"},{"key":"lt26260-bib-0013-20250824","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1002\/lt.20204","article-title":"Liver transplantation for acute liver failure from drug induced liver injury in the United States","volume":"10","year":"2004","journal-title":"Liver Transpl"},{"key":"lt26260-bib-0017-20250824","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1053\/j.gastro.2015.03.006","article-title":"Features and outcomes of 899 patients with drug\u2010induced liver injury: the DILIN prospective study","volume":"148","year":"2015","journal-title":"Gastroenterology"},{"key":"lt26260-bib-0018-20250824","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1002\/hep4.1346","article-title":"The Contents of herbal and dietary supplements implicated in liver injury in the United States are frequently mislabeled","volume":"3","year":"2019","journal-title":"Hepatol Commun"},{"key":"lt26260-bib-0019-20250824","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/j.clinthera.2005.11.004","article-title":"Herb and supplement use in the US adult population","volume":"27","year":"2005","journal-title":"Clin Ther"},{"key":"lt26260-bib-0020-20250824","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1053\/j.gastro.2019.02.002","article-title":"Incidence and etiology of drug\u2010induced liver injury in mainland China","volume":"156","year":"2019","journal-title":"Gastroenterology"},{"key":"lt26260-bib-0021-20250824","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1053\/j.gastro.2016.12.016","article-title":"Association of liver injury from specific drugs, or groups of drugs, with polymorphisms in HLA and other genes in a genome\u2010wide association 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