Alcohol abuse is the most common cause of end-stage liver disease in the United States, but many transplant centers are unwilling to accept alcoholic patients because of their supposed potential for recidivism, poor compliance with the required immunosuppression regimen and resulting failure of the
Liver transplantation for alcoholic liver disease: Current concepts and length of sobriety
โ Scribed by Joseph K. Lim; Emmet B. Keeffe
- Publisher
- John Wiley and Sons
- Year
- 2004
- Tongue
- English
- Weight
- 88 KB
- Volume
- 10
- Category
- Article
- ISSN
- 1527-6465
- DOI
- 10.1002/lt.20267
No coin nor oath required. For personal study only.
โฆ Synopsis
Key Points
- The 1-year and 5-year actuarial survival rates following liver transplantation for patients with alcoholic liver disease are 82% and 68%, respectively, in the United States and 85% and 70%, respectively, in Europe. These survival rates are similar to the outcomes of patients who undergo transplantation for other types of chronic liver disease. 2. Posttransplant improvements in health-related quality of life are similar in patients who undergo transplantation for alcoholic liver disease compared to those who undergo transplantation for other causes of end-stage liver disease. 3. Approximately 20% of patients who undergo transplantation for alcoholic liver disease use alcohol posttransplant, with one-third of these individuals exhibiting repetitive or heavy drinking. Surprisingly, little evidence exists to document a significant detrimental effect on graft or patient survival associated with resumption of drinking. 4. There are few reliable predictors of relapse in alcoholic patients after liver transplantation. Although not supported by all studies, abstinence of fewer than 6 months prior to transplantation may be a reasonable predictor of recidivism and is widely employed as a criterion for listing for liver transplantation. There are no good data to determine if some patients with sobriety fewer than 6 months might benefit from liver transplantation. (Liver Transpl 2004;
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A lcoholic liver disease (ALD) is a major cause of cirrhosis and a leading cause of death of end-stage liver disease in the United States and most of the Western world. The only means of restoring health in patients with end-stage liver disease at present is orthotopic liver transplantation. In the
We have used a formal transplant protocol to select patients with alcoholic liver disease (ALD) for transplantation. We retrospectively analyzed all the patients with ALD who were referred specifically for transplantation to our Liver Unit between 1987 and 1994. Patients were selected for liver tran
T oday, there are nearly 12,000 patients per year dying of end-stage alcoholic liver disease (ALD); with only 4,000 hepatic donor organs available per year, it is clear that all patients with ALD cannot be saved by liver transplantation. 1 Which of these patients with ALD is selected for liver trans