title: Negative outcomes after liver transplantation in patients with alcoholic liver disease beyond the fifth post-transplant year.
abstract: Although up to 50% of patients with alcoholic liver disease (ALD) resume alcohol consumption after liver transplantation (LT), numerous studies indicate that long-term results are not compromised. This study focused on evaluating the impact of ALD on outcomes up to and beyond the fifth year after LT. Among the 432 primary LT recipients included in this study, 97 underwent transplantation for ALD. Alcohol relapse rate at 10 yr was 33.5%, with younger recipient age being the only independent predictor (p = 0.019). Survival of patients with ALD (77.0%) was similar to those without (79.0%) up to the fifth post-transplant year (p = 0.655) but worse during the five subsequent years among the five-yr survivors (70.6% vs. 92.9%; p = 0.002). ALD was an independent risk factor for poorer survival beyond the fifth post-transplant year (p = 0.049), but not earlier (p = 0.717). Conversely, alcohol relapse increased the risk of death only during the first five post-transplant years (p = 0.039). There were no significant differences regarding graft failure incidence between ALD and non-ALD recipients up to the fifth post-transplant year (7.3% vs. 11.6%; p = 0.255) and beyond (12.9% vs. 5.0%; p = 0.126). In conclusion, pre-transplant diagnosis of ALD yields negative effects on post-transplant outcomes beyond the fifth post-transplant year, not attributable to recidivism.
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: Michał
authors: M
authors: Grąt
authors: Zbigniew
authors: Z
authors: Lewandowski
authors: Karolina
authors: K
authors: Grąt
authors: Karolina Maria
authors: KM
authors: Wronka
authors: Maciej
authors: M
authors: Krasnodębski
authors: Krzysztof
authors: K
authors: Barski
authors: Hanna
authors: H
authors: Zborowska
authors: Waldemar
authors: W
authors: Patkowski
authors: Krzysztof
authors: K
authors: Zieniewicz
authors: Marek
authors: M
authors: Krawczyk
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
keywords: alcoholic liver disease; alcoholism; liver transplantation; mortality; outcome assessment; recurrence