title: Lower relapse rates with good post-transplant outcome in alcoholic liver disease: Experience from a living donor liver transplant center.
abstract: BACKGROUND
  Post-transplant relapse is a major factor influencing the long-term outcome in alcoholic liver disease (ALD) patients.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the relapse rates following living donor liver transplantation (LDLT) in patients with ALD in the Indian context with strong family support.
  
  
  METHODS
  Of 458 patients who underwent LDLT for ALD, 408 were included in the study. Post-transplant relapse was determined by information provided by the patient and/or family by means of outpatient and e-mail questionnaire, supported by clinical/biochemical parameters/liver histopathology.
  
  
  RESULTS
  All except one were males, with a mean age of 46.9 ± 8.5 years. The overall rate of relapse was 9.5 % at 34.7 months (interquartile range (IQR) 15-57.6), lower than that reported in the literature from the West. The relapse rate was higher in patients with a shorter duration of pre-transplant abstinence (17.4 % and 15.4 % for recipients with pre-transplant abstinence of <3 and <6 months, respectively, p < 0.05). The overall survival was 88.5 % at 3 years. Of 39 patients with relapse, 16 (41 %) were occasional drinkers, 14 (35.8 %) were moderate drinkers, and 9 (23 %) were heavy drinkers. All the heavy drinkers presented with features of graft dysfunction.
  
  
  CONCLUSIONS
  Good results can be obtained following LDLT for ALD, with significantly lower relapse rates in our setup as compared to the West.
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India. sanjivsaigal@hotmail.com.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Saigal
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Narendra Singh
authors.initials: NS
authors.lastname: Choudhary
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Yadav
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Saraf
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Rai
authors.affiliation: Department of Mental Health and Quality of Life, Medanta - The Medicity, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Mehrotra
authors.affiliation: Department of Mental Health and Quality of Life, Medanta - The Medicity, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Vipul
authors.initials: V
authors.lastname: Rastogi
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Rastogi
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Goja
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Bhangui
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Sumana K
authors.initials: SK
authors.lastname: Ramachandra
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Raut
authors.affiliation: Department of Histopathology, Medanta - The Medicity, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gautam
authors.affiliation: Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India.
authors.forename: Arvinder Singh
authors.initials: AS
authors.lastname: Soin
mesh_terms: D000328:Adult; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: Alcoholic liver disease; Liver transplant; Living donor liver transplantation