Negative impact of de novo malignancies rather than alcohol relapse on survival after liver transplantation for alcoholic cirrhosis: a retrospective analysis of 305 patients in a single center.

Abstract

OBJECTIVES:

Alcoholic liver disease is a leading indication for liver transplantation (LT). The aim of this study was to evaluate long-term results and survival prognostic factors of LT in this indication from a large cohort of patients.

METHODS:

From October 1990 to October 2005, 305 consecutive patients with alcoholic cirrhosis (from 594 patients presenting with cirrhosis, i.e., 51.3%) underwent LT in our center. There were 229 men and 76 women, with a median age of 50 yr (range 30-68). Clinical and biological variables with possible prognostic value were analyzed.

RESULTS:

Global survival rate was 92.6% at 1 yr, 88.5% at 3 yr, 84.3% at 5 yr, and 73.4% at 10 yr, and was similar (P=0.78, log-rank test) to that of patients transplanted for other cirrhosis (88.8% at 1 yr, 84.1% at 3 yr, 80.6% at 5 yr, and 74.7% at 10 yr). Recurrence of alcohol consumption was observed in 37 patients (12.1%). De novo cancer occurred in 35 patients after LT (11.5%). Univariate analysis disclosed that male gender, history of smoking, and de novo carcinoma were significant survival prognostic factors (P<0.05, log-rank test).

CONCLUSIONS:

Our results strongly confirm that alcoholic liver disease is an excellent indication for LT, but long-term survival is reduced because of other target-organ damage of both alcohol and tobacco, especially aero-digestive malignancies, which are greater causes of morbidity and mortality than is recurrent alcohol liver disease.

• Authors: Jérôme Dumortier, Olivier Guillaud, Mustapha Adham, Catherine Boucaud, Bertrand Delafosse, Yves Bouffard, Pierre Paliard, Jean-Yves Scoazec, Olivier Boillot
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 102 Issue 5 Pg. 1032-41 (May 2007) ISSN: 0002-9270 [Print] United States
• PMID: 17313502 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Alcohol Drinking (adverse effects)
• Cause of Death
• Chi-Square Distribution
• Female
• Humans
• Liver Cirrhosis, Alcoholic (surgery)
• Liver Transplantation
• Male
• Middle Aged
• Neoplasms (pathology)
• Prognosis
• Proportional Hazards Models
• Recurrence
• Reoperation
• Retrospective Studies
• Risk Factors
• Survival Rate
• Treatment Outcome