ORTHOTOPIC LIVER-TRANSPLANTATION FOR ALCOHOLIC LIVER-DISEASE - RATES OF SURVIVAL, COMPLICATIONS AND RELAPSE

Background/Aims: Liver transplantation, for alcoholic end-stage liver disease remains controversial at many transplant centers. The aim of t he present study was to evaluate the outcome of patients with alcoholi c liver disease who underwent liver transplantation at Centro Trapiant i, Policlinico S. Orsola, Bologna. Methodology: We describe the outcom es of 18 alcoholic patients with end-stage liver disease who received orthotopic liver transplants at our center from April, 1986 to Februar y, 1996. The data obtained was compared with that of 114 patients with virus-related cirrhosis selected as transplant controls. An absolute period of abstinence from alcohol consumption for at least six months was required. Results: Regarding the actuarial survival rate and non-f atal post-transplant complications, no significant differences were no ted in comparing the non-alcoholic with the alcoholic recipients, exce pt for a higher incidence of Cytomegalovirus infection in the alcoholi c group followed-up for more than four months. The alcoholic relapse r ate was 27.2%, but only one patient returned to harmful drinking. Seve nty-three percent of subjects who were followed-up for at least six mo nths were occupied in gainful employment. Alcoholic relapse did not af fect employment status. Conclusion: This data demonstrates that liver transplantation for selected patients with end-stage alcohol-related c irrhosis achieves good results in survival, complications and employme nt status, and it appears difficult to defend an inflexible claim to h ave demonstrated an absolute long-term abstinence before transplantati on when a severe deterioration of liver function is present.