Liver Transplantation for Alcoholic Liver Disease: An Analysis on the Posttransplant Course and Alcoholic Relapse / 대한이식학회지

ABSTRACT

PURPOSE: Alcoholic liver disease (ALD) has been one of the most common causes of cirrhosis in Western countries, and its incidence has been increasing recently in Korea. In this study, we investigated the clinical course and outcome of liver transplantation in ALD patients with special attention to specific risk of alcohol relapse. METHODS: We retrospectively reviewed the clinical course, complication and survival of 18 ALD patients out of 807 liver transplants in Asan medical center from August 1992 to December 2003. Relapse of alcohol intake was investigated. The changes of liver function test were analyzed to clarify its relation with alcoholic relapse. RESULTS: Of these 18 patients, 2 (11%) died and 4 (22%) experienced alcoholic relapse. Alcoholic relapsers showed significant deterioration of serum AST, ALT and total bilirubin levels in acute stage comparing with non-relapsers, but such functional deteriorations resolved after recovery period of abstinence. Recipient age at the time of liver transplantation and abstinence not more than 6 months prior to transplantation were proven as significant risk factorsfor alcoholic relapse. CONCLUSION: ALD recipient revealed favorable outcome and survival following liver transplantation. To reduce the possibility of posttransplant alcoholic relapse, pretransplant abstinence more than 6 months is highly recommended. In addition, recipient of younger age should receive adequate education and strict surveillance for abstinence.