title: Role of 6-month abstinence rule in living donor liver transplantation for patients with alcoholic liver disease.
abstract: OBJECTIVE
  Although alcoholic liver disease (ALD) is an accepted indication for liver transplantation (LT), there are several controversial issues. The aim of this study is to examine the applicability of the 6-month abstinence rule prior to LT and to evaluate the results in living donor LT for patients with ALD.
  
  
  METHODS
  A retrospective study of 102 patients with ALD referred for LT was performed. Clinical data, including alcohol consumption history, were analyzed. A period of abstinence from drinking alcohol of at least 6 months was strictly required.
  
  
  RESULTS
  Among 102 patients, 21 abstained from drinking for at least 6 months. Of these, 13 patients (12%) underwent LT, five patients (5%) recovered without LT and three patients (3%) were listed for deceased donor LT. LT was not indicated for the remaining 81 patients (80%). Eight patients died within 6 months of referral to our program. The Child-Pugh score was higher in these eight patients than in the 21 who achieved 6-month abstinence, although the alcohol consumption history variables did not significantly differ between the two groups. The 5-year overall survival rates after LT in 13 patients with ALD (91%) were similar to those in 387 non-ALD patients (83%). The rate of alcohol consumption relapse after LT was 8% (n = 1/13).
  
  
  CONCLUSIONS
  Living donor LT for patients with ALD who complied with the 6-month abstinence rule provides sufficient survival benefit with good compliance, compensating for the potential risks to the donors.
authors: Artificial Organ and Transplantation Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Yoshikuni
authors: Y
authors: Kawaguchi
authors: Yasuhiko
authors: Y
authors: Sugawara
authors: Noriyo
authors: N
authors: Yamashiki
authors: Junichi
authors: J
authors: Kaneko
authors: Sumihito
authors: S
authors: Tamura
authors: Taku
authors: T
authors: Aoki
authors: Yoshihiro
authors: Y
authors: Sakamoto
authors: Kiyoshi
authors: K
authors: Hasegawa
authors: Kayo
authors: K
authors: Nojiri
authors: Norihiro
authors: N
authors: Kokudo
keywords: abstinence period; alcohol recidivism; alcoholic liver disease; liver transplantation