Survival of patients with alcoholic and cryptogenic cirrhosis without liver transplantation: a single center retrospective study

Abstract

BackgroundThere is no recent data addressing the long term survival of cirrhosis patients without transplantation, but with the availability of optimal pharmacological and endoscopic therapies. We compared the long term transplant free survival of alcoholic (AC) and cryptogenic (CC) cirrhosis patients in a setting where liver transplantation was, until very recently, not available. AC and CC patient details were extracted from our database, maintained since 1995. For those who had not attended clinics within the past 4 weeks, the patient or families were contacted to obtain survival status. If deceased, cause of death was ascertained from death certificates and patient records. Survival was compared using Kaplan-Meier curves.ResultsComplete details were available in 549/651 (84.3%) patients (AC 306, CC 243). Mean follow up duration (SD) (months) was 29.9 (32.6). 82/96 deaths (85.4%) among AC and 80/94 deaths (85.1%) among CC were liver related. Multivariate analysis showed age at diagnosis and Child’s class predicted overall survival among all groups. The median survival in Child’s class B and C were 53.5 and 25.3 months respectively. Survival was similar among AC and CC. Among AC survival was improved by abstinence [HR = 0.63 (95% CI: 0.40-1.00)] and was worse with diabetes [HR=1.59 (95% CI: 1.02- 2.48)] irrespective of alcohol status.ConclusionsThe overall survival of AC was similar to CC. Death in both groups were predominantly liver related, and was predicated by age at diagnosis and Child class. Among AC, presence of diabetes and non-abstinence from alcohol were independent predictors for poor survival.

Clinical outcomes of cryptogenic compared with non‐cryptogenic cirrhosis: A retrospective cohort study

“…In Sri Lanka, Senanayake et al . demonstrated that cryptogenic cirrhosis patients had a similar survival rate to cases with alcoholic cirrhosis . The main cause of mortality in both cryptogenic and alcohol‐related cirrhosis was liver‐related in this cohort of Sri Lankan patients.…”

Incidence and risk factors for non‐alcoholic fatty liver disease: A 7‐year follow‐up study among urban, adult Sri Lankans

“…Hepatitis B and hepatitis C prevalence is very low even among presumed “high risk” populations . Chronic viral hepatitis related CLD is also rare (<2% for HBV and <1% for HCV related cirrhosis) . Instead, alcoholic and cryptogenic or NASH‐related forms of cirrhosis predominate .…”

“…Chronic viral hepatitis related CLD is also rare (<2% for HBV and <1% for HCV related cirrhosis) . Instead, alcoholic and cryptogenic or NASH‐related forms of cirrhosis predominate . We previously reported that 63% of cases referred for liver transplantation were related to NASH‐cirrhosis .…”

Frequency, pattern and short-term outcome of chronic renal dysfunction in patients with cirrhosis

“…This has led to an increasing contribution of nonalcoholic steatohepatitis to the burden of cirrhosis [4]. This has led to an increasing contribution of nonalcoholic steatohepatitis to the burden of cirrhosis [4].…”

“…Liver transplantation is in its infancy and it is still not widely available for most cirrhotic patients attending state sector hospitals [4]. Liver transplantation is in its infancy and it is still not widely available for most cirrhotic patients attending state sector hospitals [4].…”