Liver transplantation for alcoholic liver disease.
In many patients, long-term heavy drinking leads to chronic liver disease, liver failure, and even death. Orthotopic liver transplantation (OLT) is the only definitive treatment for end-stage liver disease, including alcoholic liver disease (ALD). Because of a shortage of donor organs, OLT for ALD patients remains controversial out of concerns that patients may resume drinking, thereby harming the transplanted organ. Therefore, transplant centers conduct careful screening procedures that assess patients' coexisting medical problems and psychosocial status to identify those patients who are medically most suited for the procedure and who are most likely to remain abstinent after OLT. Studies assessing the outcomes of ALD patients after OLT found that the survival rates of the transplanted organ and the patient were comparable to those of patients with nonalcoholic liver disease and that relapse rates among the ALD patients were low. Similarly, ALD patients and patients with other types of liver disease had comparable rates of compliance with complex medication regimens after OLT. Enhanced efforts to identify risk factors for relapse among OLT candidates with ALD and to target interventions specifically to those patients who are at high risk of relapse may further improve patient outcome and enhance the acceptance of OLT for alcoholic patients in the general population.
Anantharaju
Abhinandana
A
Liver Transplant Program, Division of Gastroenterology, Hepatology, and Nutrition, Loyola University Medical Center, Maywood, Illinois, USA.
Van Thiel
David H
DH
D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology / Q000601:surgery*; D016031:Liver Transplantation / Q000523:psychology / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology; D055502:Secondary Prevention