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Orthotopic liver transplantation for alcoholic liver disease

By S Kumar, RE Stauber, JS Gavaler, MH Basista, VJ Dindzans, RR Schade, M Rabinovitz, RE Tarter, R Gordon, TE Starzl and DH Van Thiel

Abstract

Alcohol abuse is the most common cause of end‐stage liver disease in the United States, but many transplant centers are unwilling to accept alcoholic patients because of their supposed potential for recidivism, poor compliance with the required immunosuppression regimen and resulting failure of the allograft. There is also concern that alcohol‐induced injury in other organs will preclude a good result. From July 1, 11982, to April 30, 1988, 73 patients received orthotopic liver transplants at the University of Pittsburgh for end‐stage alcoholic liver disease. Fifty‐two (71%) of these were alive at 25 ± 9 mo (mean ± S. D.) after transplantation, when a phone survey of these patients, their wives/husbands, and their physicians was performed to evaluate their subsequent use of alcohol, current medical condition and employment. Data obtained were compared with those for nonalcoholic patients selected as transplant controls. The recidivism rate has been 11.5%, with most patients drinking only socially. Fifty‐four percent of the survivors are employed, 21% classify themselves as homemakers and only 11 (21%) are unable to work. Twenty‐one patients died after transplantation; the most frequent cause of death was sepsis (43%), and intraoperative death was the next most common cause (28.6%). These data demonstrate that alcoholic patients can be transplanted successfully and achieve good health not significantly different from that of individuals transplanted for other causes. Thus orthotopic liver transplantation is a therapeutic option that should be considered for individuals with end‐stage alcoholic liver disease who desire such therapy. Copyright © 1990 American Association for the Study of Liver Disease

Year: 1990
DOI identifier: 10.1002/hep.1840110202
OAI identifier: oai:d-scholarship.pitt.edu:4490
Provided by: D-Scholarship@Pitt

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