Lower relapse rates with good post-transplant outcome in alcoholic liver disease: Experience from a living donor liver transplant center

Abstract

Good results can be obtained following LDLT for ALD, with significantly lower relapse rates in our setup as compared to the West.

Poor Outcomes after Recidivism in Living Donor Liver Transplantation for Alcohol-Related Liver Disease

“…The current series shows higher morbidity and mortality in patients with significant drinking (recidivism) after LT for ALD than in those who do not relapse. LT for ALD is associated with good survival rates; 11 however, the long-term survival is poor in patients with recidivism, likely secondary to graft loss or de novo malignancies. 1,2,[5][6][7][8] While patients with occasional alcohol intake have similar outcomes, recidivism is shown to be associated with poor survival after LT. A meta-analysis of 90 studies showed 22% alcohol relapse (95% confidence interval [CI]: 19-25%) and 14% heavy alcohol relapse (95% CI: 12-16%) at a mean follow-up of 48.4 AE 24.7 months after LT. 12 Several studies have shown poor outcomes in patients with recidivism as compared with those with no or occasional alcohol intake after undergoing LT for ALD.…”

Recidivism in Liver Transplant Recipients for Alcohol-related Liver Disease

“…Most of these studies are retrospective in nature and have used various definitions of relapse or recidivism, which makes a comparison difficult. Usually relapse is defined as any amount of alcohol intake after LT. 1,32 As discussed earlier, significant drinking (and not occasional alcohol intake) is important for prognosis. There are several definitions of significant drinking used in various studies.…”

“…All heavy drinkers presented with features of graft dysfunction. 1 Thus patients with occasional alcohol intake appear to have similar outcomes; however, those with significant alcohol intake are associated with poor survival after LT.…”

“…( J CLIN EXP HEPATOL 2021;11:387-396) A lcoholic-related liver disease (ALD) is a common etiology of end-stage liver disease and contributes to a significant proportion of patients undergoing liver transplantation (LT). 1,2 In a study from North India, ALD was indication of 26% of living donor LTs. 1 LT for ALD presents several challenges in the long term, such as recidivism and a higher risk of de novo malignancies, that may impair long-term survival as compared with other etiologies.…”

“…1,2 In a study from North India, ALD was indication of 26% of living donor LTs. 1 LT for ALD presents several challenges in the long term, such as recidivism and a higher risk of de novo malignancies, that may impair long-term survival as compared with other etiologies. 3,4 Several studies have shown that long-term survival is similar to other etiologies, whereas other studies have shown a lower survival in LT recipients with ALD, likely secondary to graft loss (recidivism) or de novo malignancies.…”