Effect of alcoholic liver disease and hepatitis C infection on waiting list and posttransplant mortality and transplant survival benefit†‡§

Abstract

Disease-specific analysis of liver transplant survival benefit, which encompasses both pre-and posttransplant events, has not been reported. Therefore, we evaluated the effect of alcoholic liver disease (ALD) and hepatitis C virus (HCV) infection on waiting list mortality, posttransplant mortality, and the survival benefit of deceased donor liver transplantation using

Prognostic Value of Metabolic Liver Function Tests: a Study on 711 Cirrhotic Patients

“…All recipients with MELD ≥ 20 had a significant survival benefit from transplantation, regardless of the DRI [18]. Moreover, Lucey et al evaluated if survival benefit can be related to the initial liver disease, and compared alcoholic liver disease and HCV-related cirrhosis [19], using again the data from the Scientific Registry of Transplant Recipients on 38,899 adult patients placed on the transplant waiting list between September 2001 and December 2006. The survival benefit of transplantation was significantly decreased among HCV+ compared with HCV-recipients with MELD scores 9-29, but was significantly increased at MELD ≥ 30.…”

Liver transplantation for alcoholic liver disease

“…19 Patients who have undergone LT for ALD have survival rates similar to those for LT recipients without a diagnosis of ALD, although mortality is increased in patients with comorbid ALD and HCV. 6,20 Indeed, in comparison with patients with other etiologies (e.g., HCV), few patients undergoing transplantation on account of ALD die because of advanced liver disease due to alcohol relapse. In contrast, death from cardiovascular causes and de novo malignancies, particularly of the aerodigestive tract, are significantly overrepresented among patients undergoing transplantation for ALD.…”

“…In contrast, a retrospective analysis of the United Network for Organ Sharing database suggested that ALD patients derived a survival benefit at relatively low MELD scores. 6 LT as a treatment for life-threatening alcoholic hepatitis is particularly controversial. Factors that determine the reversibility of ALD (with or without superimposed alcoholic hepatitis) in response to alcohol abstinence are largely unknown.…”

Liver transplantation: filling the gapbetween supply and demand

“…The combination of ALD and HCV has a significant impact on the waiting list mortality as well as posttransplant mortality 13 and all HCV recipients are advised to abstain from alcohol.…”