Orthotopic liver transplantation for alcoholic liver disease: A retrospective analysis of survival, recidivism, and risk factors predisposing to recidivism

The aim of this study performed at the Liver Unit at the Queen Elizabeth Ho spital, Birmingham, UK, is to assess posttransplantation alcohol consumptio n and identify risk factors associated with recidivism, This retrospective case-control study used a self-report questionnaire to assess pretransplant ation and posttransplantation drinking, and a retrospective cohort study us ed patient notes to analyze risk factors for recidivism, Of 64 patients who underwent transplantation for alcoholic liver disease (ALD) between May 19 96 and November 1999, a total of 49) surviving patients (40 men, 9 women) w ere available for study. The comparison group consisted of 49 patients matc hed for age, sex, and date of transplantation who underwent transplantation for non-alcohol-induced chronic liver disease. Two-year patient survival r ates were 82% in both study groups. The questionnaire response rate was 69. 3% and 75.5% in patients with and without ALD, respectively, Data on recidi vism (defined as any alcohol consumption after transplantation) were availa ble in 46 of the 49 patients with ALD. Of these, 45.6% were drinking; 21.7% reported only occasionally drinking; 17,3%, moderate drinking; and 6,5%, h eavy drinking. Information on alcohol consumption was available from 41 of the 49 controls. Of these, 52.5% consumed alcohol; 22.0% reported drinking only on special occasions; 24,4%, moderate drinking; and 4,9%, a return to heavy drinking. However, these differences were not statistically significa nt, and log-rank analysis found no significant difference in time to resump tion of drinking. In the ALD cohort, no significant risk factors were ident ified to predict recidivism, No pretransplantation risk factors (including period of abstinence before transplantation) correlated with recidivism, Su rvival after transplantation for ALD is similar to that in other forms of c hronic liver disease. Recidivism rates for patients with ALD are high, but patients with ALD do not drink more than their control counterparts posttra nsplantation. In most instances, alcohol consumption posttransplantation is minimal to moderate (< 20 units/wk) and seems to be controlled.