Liver transplantation for alcoholic liver disease

G. B. Zibari, D. Edwin, L. Wall, A. Diehl, Jeffrey Fair, J. Burdick, A. Klein

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Orthotopic liver transplantation (OLT) for individuals with alcoholic liver disease (ALD) remains controversial. This review was designed to evaluate the survival, recidivism, and rehabilitation of the alcoholic liver transplant recipient in a single transplant center. Methods: Between 10/86 and 11/92 203 liver transplants were performed in 179 patients. In 42 patients (23%) the primary etiologic diagnosis was ALD (36 males, 6 females, median age 47 yr). All ALD patients were evaluated preoperatively by social service, psychiatry, and medical psychology, in addition to hepatology and transplant surgery. A minimum abstinence period of 3-6 months was encouraged, although exceptions were made for cases of extreme medical urgency in which a good prognosis for abstinence was predicted. Results: In OLT recipients with ALD, actuarial survival at 1, 2, and 3 yr was 74%, 71%, and 71%, respectively, compared to 71%, 71%, and 69% for all OLT recipients. One- and two-year survival was 85% in the most recently transplanted 86 patients, 20 of whom (23%) had ALD with 1- and 2-yr survival of 84% (N.S.). Recidivism was monitored postoperatively by interviews with the patient and family, supplemented by random urine and serum toxicology. Of the 29 survivors, 2 (7%) returned temporarily to alcohol use but are presently abstinent. Although none of the ALD patients in this study was able to work prior to OLT, 76% of the survivors at least 4 months post-transplantation were employed. Conclusions: Although our experience is small, our results suggest that OLT is appropriate therapy for carefully selected patients with end-stage liver failure due to ALD. The multi-disciplinary approach to preoperative evaluation of the alcoholic liver transplant candidate is effective in determining those patients committed to abstinence after a successful transplant.

Original languageEnglish (US)
Pages (from-to)676-679
Number of pages4
JournalClinical Transplantation
Volume10
Issue number6 II
StatePublished - Dec 1996
Externally publishedYes

Fingerprint

Alcoholic Liver Diseases
Liver Transplantation
Transplants
Survival
Survivors
Liver
Medical Psychology
Community Psychiatry
Liver Failure
Gastroenterology
Social Work
Toxicology
Rehabilitation
Transplantation
Alcohols
Urine
Interviews
Serum

Keywords

  • Alcoholic liver disease (ALD)
  • Orthotopic liver transplantation (OLT)

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Zibari, G. B., Edwin, D., Wall, L., Diehl, A., Fair, J., Burdick, J., & Klein, A. (1996). Liver transplantation for alcoholic liver disease. Clinical Transplantation, 10(6 II), 676-679.

Liver transplantation for alcoholic liver disease. / Zibari, G. B.; Edwin, D.; Wall, L.; Diehl, A.; Fair, Jeffrey; Burdick, J.; Klein, A.

In: Clinical Transplantation, Vol. 10, No. 6 II, 12.1996, p. 676-679.

Research output: Contribution to journalArticle

Zibari, GB, Edwin, D, Wall, L, Diehl, A, Fair, J, Burdick, J & Klein, A 1996, 'Liver transplantation for alcoholic liver disease', Clinical Transplantation, vol. 10, no. 6 II, pp. 676-679.
Zibari GB, Edwin D, Wall L, Diehl A, Fair J, Burdick J et al. Liver transplantation for alcoholic liver disease. Clinical Transplantation. 1996 Dec;10(6 II):676-679.
Zibari, G. B. ; Edwin, D. ; Wall, L. ; Diehl, A. ; Fair, Jeffrey ; Burdick, J. ; Klein, A. / Liver transplantation for alcoholic liver disease. In: Clinical Transplantation. 1996 ; Vol. 10, No. 6 II. pp. 676-679.
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abstract = "Orthotopic liver transplantation (OLT) for individuals with alcoholic liver disease (ALD) remains controversial. This review was designed to evaluate the survival, recidivism, and rehabilitation of the alcoholic liver transplant recipient in a single transplant center. Methods: Between 10/86 and 11/92 203 liver transplants were performed in 179 patients. In 42 patients (23{\%}) the primary etiologic diagnosis was ALD (36 males, 6 females, median age 47 yr). All ALD patients were evaluated preoperatively by social service, psychiatry, and medical psychology, in addition to hepatology and transplant surgery. A minimum abstinence period of 3-6 months was encouraged, although exceptions were made for cases of extreme medical urgency in which a good prognosis for abstinence was predicted. Results: In OLT recipients with ALD, actuarial survival at 1, 2, and 3 yr was 74{\%}, 71{\%}, and 71{\%}, respectively, compared to 71{\%}, 71{\%}, and 69{\%} for all OLT recipients. One- and two-year survival was 85{\%} in the most recently transplanted 86 patients, 20 of whom (23{\%}) had ALD with 1- and 2-yr survival of 84{\%} (N.S.). Recidivism was monitored postoperatively by interviews with the patient and family, supplemented by random urine and serum toxicology. Of the 29 survivors, 2 (7{\%}) returned temporarily to alcohol use but are presently abstinent. Although none of the ALD patients in this study was able to work prior to OLT, 76{\%} of the survivors at least 4 months post-transplantation were employed. Conclusions: Although our experience is small, our results suggest that OLT is appropriate therapy for carefully selected patients with end-stage liver failure due to ALD. The multi-disciplinary approach to preoperative evaluation of the alcoholic liver transplant candidate is effective in determining those patients committed to abstinence after a successful transplant.",
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