Transplantation for alcohol-related liver disease
DOI:
https://doi.org/10.52784/27112330.127Keywords:
alcoholic hepatitis, fatty liver, liver cirrhosis, hepatocellular carcinoma, liver transplantation.Abstract
Alcoholic liver disease is one of the most prevalent liver diseases worldwide, and a major cause of morbidity and mortality. The disease can progress from mild stages, such as alcoholic fatty liver, to severe conditions including cirrhosis, and in some cases hepatocellular carcinoma. Furthermore, severe alcohol steatohepatitis and alcoholic cirrhosis can lead to alcoholic hepatitis, which is an acute presentation of alcoholic liver disease associated with high mortality. Despite treatment, between 30% and 50% of patients with severe alcoholic hepatitis eventually die. In the case of advanced disease, liver transplantation may be the only option for patient survival. Transplantation for alcoholic hepatitis has been a controversial topic, and some countries still apply the “6-month rule”, in which this time of alcohol abstinence is required prior to surgery. Emerging studies are recommending liver transplantation in severe alcoholic hepatitis not responding to medical therapies even without the required abstinence period, since the majority of these patients would die within 6 months. Further studies are needed to help refine the selection of suitable patients who have been abstinent for less than 6 months. Prevention and treatment of alcoholic liver disease must be comprehensive, with a multidisciplinary approach that includes the management of alcohol dependence, as well as pharmacological or surgical options according to the needs of each patient.
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