Liver transplantationCandidateEfficacy of 6-Month Pretransplant Abstinence for Patients With Alcoholic Liver Disease Undergoing Living Donor Liver Transplantation
Section snippets
Materials and methods
From February 1997 to December 2003, 580 adult-to-adult LDLTs were performed in our institution.12 Of these, 20 recipients were diagnosed with ALD, but five were excluded due to concurrent association with viral hepatitis or other diseases. All 15 patients were confirmed as having ALD, by both a history of chronic alcohol intake and a profile of biochemical parameters. Alcoholic cirrhosis was later confirmed by histological examination of the explanted liver.
Criteria for liver transplantation
Patient and Donor Profiles
The demographic profiles of the 15 patients are summarized in Table 1. Twelve patients (80%) manifested complications associated with portal hypertension. All patients underwent LDLT within 3 months of enrollment. Of the 15 patients, 4 (26.7%) did not meet the 6-month abstinence rule, but none of these underwent transplantation in an urgent or emergency situation. Eleven patients (73.3%) received single grafts, and 4 (26.7%) received dual grafts. All donors were related to the recipients; there
Discussion
ALD is a leading cause of end-stage liver disease in Western countries, resulting in 7.9 deaths per 100,000 individuals in the United States.13 The mortality rates of advanced alcoholic cirrhosis are extremely high, with 1- and 5-year mortality rates of 49% and 71%, respectively.14 As a result, alcoholic cirrhosis is one of the most common causes of liver transplantation in Western countries. Although little is known about the optimal timing of liver transplantation in ALD patients, prognostic
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Correlates and outcomes of alcohol use after single solid organ transplantation: A systematic review and meta-analysis
2019, Transplantation ReviewsCitation Excerpt :After title and abstract screening, 513 of 5331 references were eligible for full text analysis. Excluding 4 companion papers, 2 duplicate publications and 431 papers that did not fulfill the inclusion criteria, data on correlates and outcomes from 76 studies were extracted and summarized (Fig. 1) [26–101]. Given that 2 publications enrolled the same cohort of patients, but reported different findings [89,90], study characteristics and quality appraisal was reported for 75 unique studies only.
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2014, Transplantation ProceedingsCitation Excerpt :This anti-HBc positivity can induce de novo HBV infection in recipients positive for anti-HBs as well as in HBV-naive recipients. Thus, a prophylactic regimen is mandatory to prevent de novo HBV infection [7,25,26]. In the very early period of this study, we had provided only short-term prophylaxis for ALD recipients showing a high titer of anti-HBs, but we experienced 2 cases of de novo HBV infection.
Liver transplantation for end-stage alcoholic liver disease: a single-center experience from mainland China
2010, AlcoholCitation Excerpt :In theory, alcohol recidivism will repeat the process of alcohol-related liver injury, even leading to graft dysfunction. Numerous studies indicate that alcohol recidivism indeed damages the donor liver and leads to poor compliance with immunosuppressive agents, thereby reducing the long-term survival rate of the allograft and recipient (Conjeevaram et al., 1999; Hwang et al., 2006). At present, there exists no reliable forecasting model to predict whether or not ALD patients will relapse.
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