Orthotopic liver transplantation for alcoholic liver disease: rates of survival, complications and relapse.
OBJECTIVE
Liver transplantation for alcoholic end-stage liver disease remains controversial at many transplant centers. The aim of the present study was to evaluate the outcome of patients with alcoholic liver disease who underwent liver transplantation at Centro Trapianti, Policlinico S. Orsola, Bologna.


METHODS
We describe the outcomes of 18 alcoholic patients with end-stage liver disease who received orthotopic liver transplants at our center from April, 1986 to February, 1996. The data obtained was compared with that of 114 patients with virus-related cirrhosis selected as transplant controls. An absolute period of abstinence from alcohol consumption for at least six months was required.


RESULTS
Regarding the actuarial survival rate and non-fatal post-transplant complications, no significant differences were noted in comparing the non-alcoholic with the alcoholic recipients, except for a higher incidence of Cytomegalovirus infection in the alcoholic group followed-up for more than four months. The alcoholic relapse rate was 27.2%, but only one patient returned to harmful drinking. Seventy-three percent of subjects who were followed-up for at least six months were occupied in gainful employment. Alcoholic relapse did not affect employment status.


CONCLUSIONS
This data demonstrates that liver transplantation for selected patients with end-stage alcohol-related cirrhosis achieves good results in survival, complications and employment status, and it appears difficult to defend an inflexible claim to have demonstrated an absolute long-term abstinence before transplantation when a severe deterioration of liver function is present.
Stefanini
G F
GF
Divisione di Medicina Interna, Ospedale di Faenza (Ra).
Biselli
M
M
Grazi
G L
GL
Iovine
E
E
Moscatello
M R
MR
Marsigli
L
L
Foschi
F G
FG
Caputo
F
F
Mazziotti
A
A
Bernardi
M
M
Gasbarrini
G
G
Cavallari
A
A
D000206:Actuarial Analysis; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D013695:Temperance; D016896:Treatment Outcome