Liver transplantation alcohol related liver disease: (deliberately) stirring a hornet's nest!

O'Grady, J. G.
November 2006
Gut;Nov2006, Vol. 55 Issue 11, p1529
Academic Journal
Outcomes after liver transplantation for alcohol related liver disease compare very favourably with those documented for other causes of cirrhosis. Despite this, 5% or less of patients with advanced alcohol related liver disease are considered for transplantation. The reasons for this are complex but include professional reluctance to refer these patients for formal assessment as well as a limited and dwindling number of organs available for transplantation. Demonstrating abstinence from alcohol consumption remains central to the assessment of candidates for transplantation. Return to alcohol consumption after transplantation can follow a pattern of abuse with consequences for health and survival but may also be controlled and of little clinical significance. A better understanding of the issues influencing these outcomes should decrease the tension that currently exists between patient expectations, professional opinion, and the attitude of the general public who gift organs for donation.


Related Articles

  • Complications of orthotopic liver transplantation: imaging findings. Boraschi, P.; Donati, F. // Abdominal Imaging;Mar/Apr2004, Vol. 29 Issue 2, p189 

    Orthotopic liver transplantation has become the major treatment for end-stage chronic liver disease and for severe acute liver failure. Despite the improvement in survival due to advances in organ preservation, improved immunosuppressive therapy agents, and refinement of surgical techniques,...

  • liver transplant. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p473 

    An encyclopedia entry for "liver transplant" is presented. It refers to a procedure that replaces a diseases liver with a healthy liver coming from a donor. It is noted that the usual donor is a dead person but there are times when part of the liver is obtained from a living relative of the...

  • Early Liver Transplantation for Severe Alcoholic Hepatitis. Mathurin, Philippe; Moreno, Christophe; Samuel, Didier; Dumortier, J�r�me; Salleron, Julia; Durand, Fran�ois; Castel, H�l�ne; Duhamel, Alain; Pageaux, Georges-Philippe; Leroy, Vincent; Dharancy, S�bastien; Louvet, Alexandre; Boleslawski, Emmanuel; Lucidi, Valerio; Gustot, Thierry; Francoz, Claire; Letoublon, Christian; Castaing, Denis; Belghiti, Jacques; Donckier, Vincent // New England Journal of Medicine;11/10/2011, Vol. 365 Issue 19, p1790 

    Background: A 6-month abstinence from alcohol is usually required before patients with severe alcoholic hepatitis are considered for liver transplantation. Patients whose hepatitis is not responding to medical therapy have a 6-month survival rate of approximately 30%. Since most alcoholic...

  • Transplantation for alcoholic liver disease. Webb, Kerry; Neuberger, James // BMJ: British Medical Journal (International Edition);7/10/2004, Vol. 329 Issue 7457, p63 

    Presents an editorial on the issues and controversies surrounding the issue of liver transplantation for patients with alcoholic liver disease. Risks of uninformed debate, including fewer organ donations; Why transplants are appropriate for selected people with alcohol induced liver damage;...

  • Alcoholics and Liver Transplantation. Cohen, Carl; Benjamin, Martin // JAMA: Journal of the American Medical Association;3/13/91, Vol. 265 Issue 10, p1299 

    Presents arguments underlying a widespread unwillingness to consider patients with alcoholic cirrhosis of the liver as candidates for transplantation. Reasons for precluding alcoholics as candidates for liver transplantation; Moral and medical argument on the issue; Selection process of liver...

  • Adult—adult living donor liver transplantation. Makuuchi, Masatoshi; Miller, Charles M.; Olthoff, Kim; Schwartz, Myron // Journal of Gastrointestinal Surgery;Mar2004, Vol. 8 Issue 3, p303 

    After the first report from Denver in 1998 of a successful liver transplant in an adult using the right lobe from a living donor, the procedure was rapidly adopted by many transplant centers as a potential solution to the critical shortage of donor livers. By the end of 2000, when the National...

  • What you should know about living donor liver transplantation. Brown Jr., Robert S.; Everson, Gregory T.; Glaser, Vicki // Patient Care;Dec2004, Vol. 38 Issue 12, p26 

    Offers several facts about adult living donor liver transplantation. Role of a primary care physician when a patient consults about becoming a liver donor; Reason behind the need of living donor transplant; Information on how to educate patients about being a living donor.

  • Trends in adult-to-adult living donor liver transplant organ donation: the Johns Hopkins experience. Abougergi, Marwan S.; Rai, Rudra; Cohen, Cynthia K.; Montgomery, Robert; Solga, Steven F. // Progress in Transplantation;Mar2006, Vol. 16 Issue 1, p28 

    Adult-to-adult living donor liver transplantation is an increasingly important option for 17 000 patients awaiting liver transplantation in the United States. However, adult-to-adult living donor liver transplantation volumes peaked in 2001 (N=518), and have gradually fallen in 2002 (N=362),...

  • Biliary complications after a right-lobe living donor liver transplantation. Yazumi, Shujiro; Chiba, Tsutomu // Journal of Gastroenterology;Sep2005, Vol. 40 Issue 9, p861 

    Right-lobe living donor liver transplantation (RL-LDLT) has become an acceptable procedure for adult patients with end-stage liver disease in this decade. However, biliary complications in RL-LDLT remain a serious problem: the incidence of anastomotic biliary leakage and stricture after RL-LDLT...


Read the Article


Sign out of this library

Other Topics