Negative outcomes after liver transplantation in patients with alcoholic liver disease beyond the fifth post-transplant year.

Abstract

Although up to 50% of patients with alcoholic liver disease (ALD) resume alcohol consumption after liver transplantation (LT), numerous studies indicate that long-term results are not compromised. This study focused on evaluating the impact of ALD on outcomes up to and beyond the fifth year after LT. Among the 432 primary LT recipients included in this study, 97 underwent transplantation for ALD. Alcohol relapse rate at 10 yr was 33.5%, with younger recipient age being the only independent predictor (p = 0.019). Survival of patients with ALD (77.0%) was similar to those without (79.0%) up to the fifth post-transplant year (p = 0.655) but worse during the five subsequent years among the five-yr survivors (70.6% vs. 92.9%; p = 0.002). ALD was an independent risk factor for poorer survival beyond the fifth post-transplant year (p = 0.049), but not earlier (p = 0.717). Conversely, alcohol relapse increased the risk of death only during the first five post-transplant years (p = 0.039). There were no significant differences regarding graft failure incidence between ALD and non-ALD recipients up to the fifth post-transplant year (7.3% vs. 11.6%; p = 0.255) and beyond (12.9% vs. 5.0%; p = 0.126). In conclusion, pre-transplant diagnosis of ALD yields negative effects on post-transplant outcomes beyond the fifth post-transplant year, not attributable to recidivism.

• Authors: Michał Grąt, Zbigniew Lewandowski, Karolina Grąt, Karolina Maria Wronka, Maciej Krasnodębski, Krzysztof Barski, Hanna Zborowska, Waldemar Patkowski, Krzysztof Zieniewicz, Marek Krawczyk
• Journal: Clinical transplantation (Clin Transplant) Vol. 28 Issue 10 Pg. 1112-20 (Oct 2014) ISSN: 1399-0012 [Electronic] Denmark
• PMID: 25059535 (Publication Type: Journal Article)
• Copyright: © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Topics

• Adult
• Female
• Follow-Up Studies
• Graft Rejection (etiology)
• Graft Survival
• Humans
• Liver Diseases, Alcoholic (mortality, surgery)
• Liver Transplantation
• Male
• Middle Aged
• Postoperative Complications
• Recurrence
• Risk Factors
• Survival Rate
• Treatment Outcome