Alcoholic liver disease is a consolidated indication for liver transplantation, but many unsolved issues can be highlighted. Patients with alcohol use disorder develop peculiar comorbidities that can become contraindications for transplantation. Moreover, a number of social and psychological patterns should be evaluated to select candidates with a low risk of alcohol relapse and adequate post-transplant adherence. In this context, the 6-month rule is too rigid to be widely applied. A short period of abstinence (1 to 3 months) is useful to estimate recovery of liver function and, possibly to avoid transplant. Cardiovascular disorders and extra-hepatic malignancies represent the main clinical issues after transplant. Patients transplanted due to alcoholic disease are a major risk for other liver diseases. Severe corticosteroid-resistant alcoholic acute hepatitis is a debated indication for transplant. However, available data indicate that well-selected patients have excellent post-transplant outcomes. Behavioral therapy, continued psychological support and a multidisciplinary team are essential to achieve and maintain complete alcohol abstinence during the transplant process. Alcoholic liver disease is an excellent indication for a liver transplant but patients with alcohol use disorder deserve a personalized approach and dedicated resources.

Gitto S., Aspite S., Golfieri L., Caputo F., Vizzutti F., Grandi S., et al. (2020). Alcohol use disorder and liver transplant: New perspectives and critical issues. KOREAN JOURNAL OF INTERNAL MEDICINE, 35(4), 797-810 [10.3904/KJIM.2019.409].

Alcohol use disorder and liver transplant: New perspectives and critical issues

Gitto S.
Primo
;
Golfieri L.
Secondo
;
Caputo F.;Grandi S.;
2020

Abstract

Alcoholic liver disease is a consolidated indication for liver transplantation, but many unsolved issues can be highlighted. Patients with alcohol use disorder develop peculiar comorbidities that can become contraindications for transplantation. Moreover, a number of social and psychological patterns should be evaluated to select candidates with a low risk of alcohol relapse and adequate post-transplant adherence. In this context, the 6-month rule is too rigid to be widely applied. A short period of abstinence (1 to 3 months) is useful to estimate recovery of liver function and, possibly to avoid transplant. Cardiovascular disorders and extra-hepatic malignancies represent the main clinical issues after transplant. Patients transplanted due to alcoholic disease are a major risk for other liver diseases. Severe corticosteroid-resistant alcoholic acute hepatitis is a debated indication for transplant. However, available data indicate that well-selected patients have excellent post-transplant outcomes. Behavioral therapy, continued psychological support and a multidisciplinary team are essential to achieve and maintain complete alcohol abstinence during the transplant process. Alcoholic liver disease is an excellent indication for a liver transplant but patients with alcohol use disorder deserve a personalized approach and dedicated resources.
2020
Gitto S., Aspite S., Golfieri L., Caputo F., Vizzutti F., Grandi S., et al. (2020). Alcohol use disorder and liver transplant: New perspectives and critical issues. KOREAN JOURNAL OF INTERNAL MEDICINE, 35(4), 797-810 [10.3904/KJIM.2019.409].
Gitto S.; Aspite S.; Golfieri L.; Caputo F.; Vizzutti F.; Grandi S.; Patussi V.; Marra F.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/790099
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