No systematic evaluation has been performed previously in the Scandinavian countries on patients transplanted for alcoholic liver disease (ALD).
Data are limited on the impact of structured management of the alcohol problem on the risk of recidivism following transplantation in ALD.
Dr Björnsson and colleagues from Gothenburg, Sweden undertook a study of 103 ALD patients and compared them to a control group of patients with non-alcoholic liver disease (NALD).
In addition, the research team compared the recidivism rates for ALD patients transplanted between 1988 and 1997 with those after 1998 (institution of structured management).
The median follow-up was 31 (6-60) months in the ALD group and 37 (12-63) months in the control group (NS).
The researchers found that the overall survival rates at 1- and 5 years were, respectively, 81% and 69% for the ALD group and 87% and 83% for the non-alcoholic group.
|33% of the ALD patients resumed taking some alcohol after transplantation|
|Scandinavian Journal of Gastroenterology|
The research team noted that the proportion of patients with Child-Pugh C (75%) was higher in ALD patients than in NALD patients (44%).
The researchers observed that 33% of the ALD patients resumed taking some alcohol after transplantation; 18% of those were heavy drinkers.
The team performed a multivariate analysis which showed that: sex, age, marital and employment status, benzodiazepine use and a history of illicit drug abuse did not predict the risk of alcohol relapse post-Tx.
The researchers found that 48% of patients transplanted before the start of structured management had resumed alcohol but only 22% after this intervention.
Dr Björnsson concluded, "ALD is a good indication for liver transplantation, with similar results in the ALD patients."
"Structured management of the alcohol problem before and after transplantation is important in minimizing the risk of recidivism."