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Indication of liver transplantation in severe alcoholic liver cirrhosis: quantitative evaluation and optimal timing.

Abstract：

BACKGROUND/AIMS:The aim of our study was to evaluate the proportion of patients with severe alcoholic cirrhosis who would need orthotopic liver transplantation (OLT) and to determine the optimal delay to evaluate an abstinent patient for transplantation. METHODS:Survival without OLT, improvement in liver function and need for OLT were studied in all patients admitted in 1997 for a first episode of Child-Pugh C alcoholic cirrhosis. RESULTS:Twenty-six percent (19/74) of patients died during the initial hospitalization. The cumulative survival rates after 6 months and 1, 2 and 3 years were 56, 36, 35 and 24%, respectively. One liver transplantation (1.3%, 95% confidence interval 0.0-3.9) was performed for persisting liver failure despite abstinence. Improvement of the Child-Pugh score was observed within 3 months in 66% of the abstinent patients. OLT was indicated in four patients without liver improvement despite abstinence, but was contraindicated in three. CONCLUSIONS:Only a few patients with severe alcoholic cirrhosis undergo OLT, since most of them do not stop drinking and/or die soon, and those becoming abstinent often improve their liver function. OLT should be considered when improvement in liver function is lacking after 3 months of abstinence.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Veldt BJ,Lainé F,Guillygomarc'h A,Lauvin L,Boudjema K,Messner M,Brissot P,Deugnier Y,Moirand R

doi

10.1016/s0168-8278(01)00228-8

subject

Has Abstract

pub_date

2002-01-01 00:00:00

pages

93-8

issue

1

eissn

0168-8278

issn

1600-0641

pii

S0168827801002288

journal_volume

36

pub_type

杂志文章

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