Aim: Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis.Methods: data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed.Results: There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation.Conclusion: ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking.Short Summary: No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.

Vassallo, G., Tarli, C., Rando, M., Mosoni, C., Mirijello, A., Agyei-nkansah, A., Antonelli, M., Sestito, L., Perotti, G., Di Giuda, D., Agnes, S., Grieco, A., Gasbarrini, A., Addolorato, G., Liver Transplantation in Patients with Alcoholic Liver Disease: A Retrospective Study, <<ALCOHOL AND ALCOHOLISM>>, 2018; 53 (2): 151-156 [http://hdl.handle.net/10807/171450]

Liver Transplantation in Patients with Alcoholic Liver Disease: A Retrospective Study

Tarli, C;Mosoni, C;Antonelli, M;Sestito, L;Perotti, G;Di Giuda, D;Agnes, S;Grieco, A;Gasbarrini, A;Addolorato, G
2018

Abstract

Aim: Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis.Methods: data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed.Results: There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation.Conclusion: ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking.Short Summary: No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.
Inglese
Vassallo, G., Tarli, C., Rando, M., Mosoni, C., Mirijello, A., Agyei-nkansah, A., Antonelli, M., Sestito, L., Perotti, G., Di Giuda, D., Agnes, S., Grieco, A., Gasbarrini, A., Addolorato, G., Liver Transplantation in Patients with Alcoholic Liver Disease: A Retrospective Study, <<ALCOHOL AND ALCOHOLISM>>, 2018; 53 (2): 151-156 [http://hdl.handle.net/10807/171450]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/171450
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