ALCOHOLIC RECIDIVISM AFTER LIVER-TRANSPLANTATION FOR ALCOHOLIC CIRRHOSIS

Liver transplantation (LT) for alcoholic cirrhosis remains controversi al. This controversy surrounding LT in alcoholics focuses on the risk of alcohol recidivism and on potential noncompliance with the immunosu ppressive regimen, both of which result in graft failure. Our study ex amined alcohol recidivism after LT by measuring alcohol in urine and i ts repercussion on the allograft. Forty-four consecutive alcoholic pat ients and a comparison group of 17 patients receiving LT were included in this study and followed up for a mean of 39.5 +/- 19.6 months. Sev en percent (3 of 44) of patients with alcoholic liver disease and 0% o f patients in the comparison group admitted to having used alcohol aft er LT. Alcohol in urine, however, was detected in 18% (8 of 44) of the alcoholic group; therefore the true recidivism rate was higher than t he rate admitted. All patients in both groups were compliant with the medications, because the cyclosporine levels were within the therapeut ic range in all. On histologic examination the only alcohol-induced le sion found in three of the eight recidivistic patients was steatosis. Therefore, although alcoholic recidivism occurs, it does not seem to a ffect compliance to treatment profoundly or to compromise graft functi on. Therefore, LT seems justified for end-stage alcoholic cirrhosis.