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Semin Liver Dis 2004; 24(3): 249-255
DOI: 10.1055/s-2004-832938
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Transplantation in the Alcoholic Patient

Kymberly D.S Watt1 , Timothy M. McCashland1 , 2
  • 1Departments of Internal Medicine and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska
  • 2Medical Director, Liver Transplantation, University of Nebraska Medical Center, Omaha, Nebraska
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Publication History

Publication Date:
03 September 2004 (online)

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Alcoholic liver disease (ALD) is the second leading indication for transplantation in the United States. Most transplant programs in the United States require a minimum of 6 month's abstinence before transplantation is performed. Most studies have shown a recidivism rate of between 20 and 30% by 2 years after orthotopic liver transplantation (OLT). Higher rates of recidivism are reported if pre-OLT abstinence was < 6 months. The impact of recidivism on patient and graft survival is not clear because most reports include patients who consume alcohol in small amounts or infrequently. Equal post-OLT survival for ALD patients and non-ALD patients has been demonstrated, and ALD patients are not thought to suffer greater morbidity post transplant than non-ALD patients. Careful pretransplant assessment for concomitant medical and psychosocial ailments associated with alcoholism is important. Posttransplant monitoring for cardiovascular disease and withdrawal syndromes is required in the early postoperative setting, whereas monitoring for recidivism and malignancy are late postoperative issues.

KEYWORDS

Alcohol - liver disease - and transplantation

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Timothy M McCashlandM.D. 

983285 Nebraska Medical Center

Omaha, NE 68198-3285

Email: tmccash@unmc.edu

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