Transplantation in the alcoholic patient

Alcoholic liver disease (ALD) is the second leading indication for transplantation in the United States. Most transplant programs in the United States require a minimum of 6 month's abstinence before transplantation is performed. Most studies have shown a recidivism rate of between 20 and 30% b...

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Bibliographic Details
Published inSeminars in liver disease Vol. 24; no. 3; p. 249
Main Authors Watt, Kymberly D S, McCashland, Timothy M
Format Journal Article
LanguageEnglish
Published United States 01.08.2004
Subjects
Alcohol Drinking
Graft Survival
Hepatitis C - complications
Humans
Liver Diseases, Alcoholic - therapy
Liver Transplantation
Patient Selection
Recurrence
Social Support
United States
United States
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Summary:Alcoholic liver disease (ALD) is the second leading indication for transplantation in the United States. Most transplant programs in the United States require a minimum of 6 month's abstinence before transplantation is performed. Most studies have shown a recidivism rate of between 20 and 30% by 2 years after orthotopic liver transplantation (OLT). Higher rates of recidivism are reported if pre-OLT abstinence was < 6 months. The impact of recidivism on patient and graft survival is not clear because most reports include patients who consume alcohol in small amounts or infrequently. Equal post-OLT survival for ALD patients and non-ALD patients has been demonstrated, and ALD patients are not thought to suffer greater morbidity post transplant than non-ALD patients. Careful pretransplant assessment for concomitant medical and psychosocial ailments associated with alcoholism is important. Posttransplant monitoring for cardiovascular disease and withdrawal syndromes is required in the early postoperative setting, whereas monitoring for recidivism and malignancy are late postoperative issues.
ISSN:0272-8087
DOI:10.1055/s-2004-832938