Liver Transplantation for Alcoholic Liver Disease in Europe: A Study from the ELTR (European Liver Transplant Registry)

Alcohol‐related liver disease (ALD) is one of the most common indications for liver transplantation (LT). Long‐term outcome after LT for ALD versus other etiologies is still under debate. The aim of this study was to compare outcome after LT of patients with ALD, viral (VIR), and cryptogenic cirrhos...

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Bibliographic Details
Published in:American journal of transplantation 2010-01, Vol.10 (1), p.138-148
Main Authors: Burra, P., Senzolo, M., Adam, R., Delvart, V., Karam, V., Germani, G., Neuberger, J.
Format: Article
Language:English
Subjects:
Adult
Alcohol
Biological and medical sciences
Europe - epidemiology
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - mortality
Hepatitis B, Chronic - surgery
Hepatitis C virus
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - mortality
Hepatitis C, Chronic - surgery
Humans
liver cirrhosis
Liver Cirrhosis - complications
Liver Cirrhosis - mortality
Liver Cirrhosis - surgery
Liver Diseases, Alcoholic - complications
Liver Diseases, Alcoholic - mortality
Liver Diseases, Alcoholic - surgery
liver transplantation
Liver Transplantation - mortality
Liver Transplantation - statistics & numerical data
Liver, biliary tract, pancreas, portal circulation, spleen
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Miscellaneous
Other diseases. Semiology
outcome
Public health. Hygiene
Public health. Hygiene-occupational medicine
Registries - statistics & numerical data
Risk Factors
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Rate
Tissue Donors - statistics & numerical data
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Summary:Alcohol‐related liver disease (ALD) is one of the most common indications for liver transplantation (LT). Long‐term outcome after LT for ALD versus other etiologies is still under debate. The aim of this study was to compare outcome after LT of patients with ALD, viral (VIR), and cryptogenic cirrhosis. Donor, graft and recipient ELTR variables were analysed in transplants for alcoholic and nonalcoholic cirrhosis (1988–2005) and were correlated with patient survival. Causes of death and/or graft failure were compared between groups. Nine thousand eight hundred eighty ALD, 10 943 VIR, 1478 ALD + VIR and 2410 cryptogenic (CRYP) liver transplants were evaluated. One, 3, 5 and 10 years graft survival rates after LT in ALD patients were 84%, 78%, 73%, 58%, significantly higher than in VIR and CRYP (p = 0.04, p = 0.05). By multivariate analysis, ALD + VIR (RR 1.14) and viral alone (RR 1.06) were significant risk factors for mortality. De novo tumors, cardiovascular and social causes were causes of death/graft failure in higher percentage in ALD groups versus other etiologies. LT for ALD cirrhosis has a favorable outcome, however, hepatitis C virus co‐infection seems to eliminate this advantage. Screening for de novo tumors and prevention of cardiovascular complications are essential to provide better long‐term results. In Europe, patients transplanted for alcoholic liver disease have significantly better outcomes than patients with viral and cryptogenic cirrhosis, but de novo tumors, cardiovascular events and social factors were more frequent as causes of death.
ISSN:1600-6135
1600-6143
DOI:10.1111/j.1600-6143.2009.02869.x