Influence of superimposed alcoholic hepatitis on the outcome of liver transplantation for end-stage alcoholic liver disease.
OBJECTIVE
Alcoholic cirrhosis is a common indication for liver transplantation. The present study was aimed to assess the influence of superimposed alcoholic hepatitis on the outcome of liver transplantation in patients with alcoholic cirrhosis.


METHODS
Survival rates of 68 patients transplanted for alcoholic cirrhosis were compared with those of 101 patients transplanted for miscellaneous causes. Within the alcoholic group, explanted livers were searched for data of acute alcoholic hepatitis. The survival rate of patients with alcoholic hepatitis superimposed on liver cirrhosis was compared to that of patients with liver cirrhosis alone. Clinical severity of alcoholic hepatitis was assessed with Maddrey's score.


RESULTS
Survival was similar in alcoholics and patients with other causes of liver disease. Among patients transplanted for alcoholic cirrhosis, survival was similar in patients with superimposed alcoholic hepatitis (n=36) and in cases with liver cirrhosis alone (n=32). There was no difference in survival between patients with mild (n=26) and severe (n=10) alcoholic hepatitis. Seven alcoholics (10%) returned to ethanol consumption. Recidivism was not associated with either alcoholic hepatitis in the explanted liver or graft loss.


CONCLUSIONS
Survival after liver transplantation in patients with alcoholic cirrhosis plus alcoholic hepatitis detected in the explanted liver is similar to that of patients transplanted for other reasons. Even the presence of severe alcoholic hepatitis does not worsen the outcome of liver transplantation for end-stage alcoholic liver disease.
Tomé
Santiago
S
Liver Transplantation Unit, Hospital Clínico, Complejo Hospitalario Universitario, C/Choupana sn, 15706, Santiago de Compostela, Spain. mearturo@usc.es
Martinez-Rey
Carmen
C
González-Quintela
Arturo
A
Gude
Francisco
F
Brage
Antonio
A
Otero
Esteban
E
Abdulkader
Ihab
I
Forteza
Jerónimo
J
Bustamante
Manuel
M
Varo
Evaristo
E
D000328:Adult; D000368:Aged; D002423:Cause of Death; D002908:Chronic Disease; D005260:Female; D006519:Hepatitis, Alcoholic / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012720:Severity of Illness Index; D015996:Survival Rate