Liver Transplantation for Alcoholic Liver Disease in Europe: A Study from the ELTR (European Liver Transplant Registry) |
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Authors: | P. Burra M. Senzolo R. Adam V. Delvart V. Karam G. Germani J. Neuberger for ELITA of behalf of ELTR Liver Transplant Centers |
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Affiliation: | Gastroenterology, Department of Surgical and Gastroenterological Sciences, University Hospital of Padova, Padova, Italy;ELTR, Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Centre Hepato-Biliaire, UniversitéParis-Sud, Villejuif, France;Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom;For a complete list of the centers, see . |
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Abstract: | Alcohol-related liver disease (ALD) is one of the most common indications for liver transplantation (LT). Long-term outcome after LT for ALD versus other etiologies is still under debate. The aim of this study was to compare outcome after LT of patients with ALD, viral (VIR), and cryptogenic cirrhosis. Donor, graft and recipient ELTR variables were analysed in transplants for alcoholic and nonalcoholic cirrhosis (1988–2005) and were correlated with patient survival. Causes of death and/or graft failure were compared between groups. Nine thousand eight hundred eighty ALD, 10 943 VIR, 1478 ALD + VIR and 2410 cryptogenic (CRYP) liver transplants were evaluated. One, 3, 5 and 10 years graft survival rates after LT in ALD patients were 84%, 78%, 73%, 58%, significantly higher than in VIR and CRYP (p = 0.04, p = 0.05). By multivariate analysis, ALD + VIR (RR 1.14) and viral alone (RR 1.06) were significant risk factors for mortality. De novo tumors, cardiovascular and social causes were causes of death/graft failure in higher percentage in ALD groups versus other etiologies. LT for ALD cirrhosis has a favorable outcome, however, hepatitis C virus co-infection seems to eliminate this advantage. Screening for de novo tumors and prevention of cardiovascular complications are essential to provide better long-term results. |
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Keywords: | Alcohol liver cirrhosis liver transplantation outcome |
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