Alcoholic Hepatitis and Liver Transplantation
Main Article Content
Keywords
Hepatitis, Liver, Alcoholic, Transplantation
Abstract
Some authors affirm that early liver transplant (LT) provides excellent short-term survival in patients with severe alcoholic hepatitis (SAH) (1–4) and similar rates of alcohol relapse compared to patients with 6 months of abstinence. We agree with the choice of not excluding patients who manifest their decompensation with bleeding and infections (common complications of SAH) and patients with psychiatric comorbidities. Data from the literature have stated for a long time that the approach to patients with alcoholic liver disease (ALD) should be changed with no ethical or technical preconceptions. The reasons in favor of this change are as follows:
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References
1. Mathurin P, Moreno C, Samuel D, Dumortier J, Salleron J, Durand F, et al. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med. 2011;365:1790–800. http://dx.doi.org/10.1056/NEJMoa1105703
2. Immordino G, Gelli M, Ferrante R, Ferrari C, Piaggio F, Ghinolfi D, et al. Alcohol abstinence and orthotopic liver transplantation in alcoholic liver cirrhosis. Transplant Proc. 2009;41:1253–5. http://dx.doi.org/10.1016/j.transproceed.2009.03.092
3. Testino G, Borro P. Alcoholic hepatitis and liver transplantation: Is an abstinence of six months necessary? Hepato-Gastroenterology 2012;59:1–2.
4. Lee BP, Chen PH, Haugen C, Hernaez R, Gurakar A, Philosophe B, et al. Three-year results of a pilot program in early transplantation for severe alcoholic hepatitis. Ann Surg. 2017;265:20–9. http://dx.doi.org/10.1097/SLA.0000000000001831
5. Prado V, Caballería J, Vargas V, Bataller R, Altamirano J. Alcoholic hepatitis: How far are we and where are we going? Ann Hepatol. 2016;15:463–73.
6. Testino G, Burra P, Bonino F, Piani F, Sumberaz A, Peressutti R, et al. Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation. World J Gastroenterol. 2014;20:14642–51. http://dx.doi.org/10.3748/wjg.v20.i40.14642
7. Singal AK, Bashar H, Anand BS, Jampana SC, Singal V, Kuo YF, et al. Outcomes after liver transplantation for alcoholic hepatitis are similar to alcoholic cirrhosis: Exploratory analysis from the UNOS database. Hepatology 2012;55:1398–405. http://dx.doi.org/10.1002/hep.25544
8. Testino G, Sumberaz A, Borro P. Comment to “Liver transplantation for patients with alcoholic liver disease: An open question.” Dig Liver Dis. 2013;45:80–1. http://dx.doi.org/10.1016/j.dld.2012.06.003
9. Testino G, Leone S. Liver transplantation and alcoholic liver disease: A point of view. Austin Transplant Sci. 2016;1:1002–3.
10. Testino G, Leone S. Alcoholic liver disease and orthotopic liver transplantation. J Dig Dis Hepatol. 2016;2016(3).
11. Leon M, Varon J, Surani S. When a liver transplant recipient goes back to alcohol abuse: Should we be more selective? World J Gastroenterol. 2016;22:4789–93. http://dx.doi.org/10.3748/wjg.v22.i20.4789
12. Zambrano A. Why alcoholics ought to compete equally for liver transplants. Bioethics. 2016;30:689–97. http://dx.doi.org/10.1111/bioe.12274
13. Addolorato G, Mirijello A, Leggio L, Ferrulli A, D'Angelo C, Vassallo G, et al. Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center. Alcohol Clin Exp Res. 2013;37:1601–8. http://dx.doi.org/10.1111/acer.12117
14. Heckley GA, Jarl J, Asamoah BO, G-Gerdtham U. How the risk of liver cancer changes after alcohol cessation: A review and meta-analysis of the current literature. BMC Cancer. 2011;11:446. http://dx.doi.org/10.1186/1471-2407-11-446
15. IARC. A review of human carcinogens. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 100. Lyon, France: International Agency for Research on Cancer; 2011. p. 2011. http://monographs.iarc.fr/ENG/Monographs/PDFs/index.php
2. Immordino G, Gelli M, Ferrante R, Ferrari C, Piaggio F, Ghinolfi D, et al. Alcohol abstinence and orthotopic liver transplantation in alcoholic liver cirrhosis. Transplant Proc. 2009;41:1253–5. http://dx.doi.org/10.1016/j.transproceed.2009.03.092
3. Testino G, Borro P. Alcoholic hepatitis and liver transplantation: Is an abstinence of six months necessary? Hepato-Gastroenterology 2012;59:1–2.
4. Lee BP, Chen PH, Haugen C, Hernaez R, Gurakar A, Philosophe B, et al. Three-year results of a pilot program in early transplantation for severe alcoholic hepatitis. Ann Surg. 2017;265:20–9. http://dx.doi.org/10.1097/SLA.0000000000001831
5. Prado V, Caballería J, Vargas V, Bataller R, Altamirano J. Alcoholic hepatitis: How far are we and where are we going? Ann Hepatol. 2016;15:463–73.
6. Testino G, Burra P, Bonino F, Piani F, Sumberaz A, Peressutti R, et al. Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation. World J Gastroenterol. 2014;20:14642–51. http://dx.doi.org/10.3748/wjg.v20.i40.14642
7. Singal AK, Bashar H, Anand BS, Jampana SC, Singal V, Kuo YF, et al. Outcomes after liver transplantation for alcoholic hepatitis are similar to alcoholic cirrhosis: Exploratory analysis from the UNOS database. Hepatology 2012;55:1398–405. http://dx.doi.org/10.1002/hep.25544
8. Testino G, Sumberaz A, Borro P. Comment to “Liver transplantation for patients with alcoholic liver disease: An open question.” Dig Liver Dis. 2013;45:80–1. http://dx.doi.org/10.1016/j.dld.2012.06.003
9. Testino G, Leone S. Liver transplantation and alcoholic liver disease: A point of view. Austin Transplant Sci. 2016;1:1002–3.
10. Testino G, Leone S. Alcoholic liver disease and orthotopic liver transplantation. J Dig Dis Hepatol. 2016;2016(3).
11. Leon M, Varon J, Surani S. When a liver transplant recipient goes back to alcohol abuse: Should we be more selective? World J Gastroenterol. 2016;22:4789–93. http://dx.doi.org/10.3748/wjg.v22.i20.4789
12. Zambrano A. Why alcoholics ought to compete equally for liver transplants. Bioethics. 2016;30:689–97. http://dx.doi.org/10.1111/bioe.12274
13. Addolorato G, Mirijello A, Leggio L, Ferrulli A, D'Angelo C, Vassallo G, et al. Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center. Alcohol Clin Exp Res. 2013;37:1601–8. http://dx.doi.org/10.1111/acer.12117
14. Heckley GA, Jarl J, Asamoah BO, G-Gerdtham U. How the risk of liver cancer changes after alcohol cessation: A review and meta-analysis of the current literature. BMC Cancer. 2011;11:446. http://dx.doi.org/10.1186/1471-2407-11-446
15. IARC. A review of human carcinogens. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 100. Lyon, France: International Agency for Research on Cancer; 2011. p. 2011. http://monographs.iarc.fr/ENG/Monographs/PDFs/index.php
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Published
Feb 3, 2017
Article Details
How to Cite
Testino, G., & Leone, S. (2017). Alcoholic Hepatitis and Liver Transplantation. Journal of Renal and Hepatic Disorders, 1(1), 3–4. https://doi.org/10.15586/jrenhep.2017.8
Section
Editorial
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