Liver Transplantation in Patients with Alcoholic Liver Disease: A Retrospective Study

Gabriele A Vassallo, Claudia Tarli, Maria M Rando, Carolina Mosoni, Antonio Mirijello, Adwoa Agyei-Nkansah, Mariangela Antonelli, Luisa Sestito, Germano Perotti, Daniela Di Giuda, Salvatore Agnes, Antonio Grieco, Antonio Gasbarrini, Giovanni Addolorato, Gemelli OLT Group

Research output: Contribution to journalArticle

Abstract

Aim: Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis.

Methods: data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed.

Results: There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation.

Conclusion: ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking.

Short Summary: No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalAlcohol and Alcoholism
DOIs
Publication statusE-pub ahead of print - Dec 1 2017

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Alcoholic Liver Diseases
Liver
Liver Transplantation
Retrospective Studies
Alcoholic Liver Cirrhosis
Transplants
Liver Diseases
Recurrence
Fibrosis
Survival Rate
Smoking
Transplantation (surgical)
Cause of Death
Neoplasms
Transplantation
Western World
End Stage Liver Disease
Liver Failure
Early Detection of Cancer
Alcohols

Keywords

  • Journal Article

Cite this

Vassallo, G. A., Tarli, C., Rando, M. M., Mosoni, C., Mirijello, A., Agyei-Nkansah, A., ... Gemelli OLT Group (2017). Liver Transplantation in Patients with Alcoholic Liver Disease: A Retrospective Study. Alcohol and Alcoholism, 1-6. https://doi.org/10.1093/alcalc/agx097

Liver Transplantation in Patients with Alcoholic Liver Disease : A Retrospective Study. / Vassallo, Gabriele A; Tarli, Claudia; Rando, Maria M; Mosoni, Carolina; Mirijello, Antonio; Agyei-Nkansah, Adwoa; Antonelli, Mariangela; Sestito, Luisa; Perotti, Germano; Di Giuda, Daniela; Agnes, Salvatore; Grieco, Antonio; Gasbarrini, Antonio; Addolorato, Giovanni; Gemelli OLT Group.

In: Alcohol and Alcoholism, 01.12.2017, p. 1-6.

Research output: Contribution to journalArticle

Vassallo, GA, Tarli, C, Rando, MM, Mosoni, C, Mirijello, A, Agyei-Nkansah, A, Antonelli, M, Sestito, L, Perotti, G, Di Giuda, D, Agnes, S, Grieco, A, Gasbarrini, A, Addolorato, G & Gemelli OLT Group 2017, 'Liver Transplantation in Patients with Alcoholic Liver Disease: A Retrospective Study', Alcohol and Alcoholism, pp. 1-6. https://doi.org/10.1093/alcalc/agx097
Vassallo, Gabriele A ; Tarli, Claudia ; Rando, Maria M ; Mosoni, Carolina ; Mirijello, Antonio ; Agyei-Nkansah, Adwoa ; Antonelli, Mariangela ; Sestito, Luisa ; Perotti, Germano ; Di Giuda, Daniela ; Agnes, Salvatore ; Grieco, Antonio ; Gasbarrini, Antonio ; Addolorato, Giovanni ; Gemelli OLT Group. / Liver Transplantation in Patients with Alcoholic Liver Disease : A Retrospective Study. In: Alcohol and Alcoholism. 2017 ; pp. 1-6.
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abstract = "Aim: Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis.Methods: data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed.Results: There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation.Conclusion: ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking.Short Summary: No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.",
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T1 - Liver Transplantation in Patients with Alcoholic Liver Disease

T2 - A Retrospective Study

AU - Vassallo, Gabriele A

AU - Tarli, Claudia

AU - Rando, Maria M

AU - Mosoni, Carolina

AU - Mirijello, Antonio

AU - Agyei-Nkansah, Adwoa

AU - Antonelli, Mariangela

AU - Sestito, Luisa

AU - Perotti, Germano

AU - Di Giuda, Daniela

AU - Agnes, Salvatore

AU - Grieco, Antonio

AU - Gasbarrini, Antonio

AU - Addolorato, Giovanni

AU - Gemelli OLT Group

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Aim: Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis.Methods: data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed.Results: There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation.Conclusion: ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking.Short Summary: No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.

AB - Aim: Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis.Methods: data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed.Results: There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation.Conclusion: ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking.Short Summary: No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.

KW - Journal Article

U2 - 10.1093/alcalc/agx097

DO - 10.1093/alcalc/agx097

M3 - Article

C2 - 29206894

SP - 1

EP - 6

JO - Alcohol and Alcoholism

JF - Alcohol and Alcoholism

SN - 0735-0414

ER -