Histological features after liver transplantation in alcoholic cirrhotics

Background/Aims: Though alcoholic cirrhosis is a common indication for live r transplantation, it carries the risk of alcohol recidivism and consequent graft failure. This study aims to evaluate the effect of alcohol recidivis m on survival rates and histological parameters in patients transplanted fo r alcoholic cirrhosis, with and without hepatitis C virus (HCV) infection. Methods: Fifty-one out of 189 consecutive transplanted patients underwent p sychosocial evaluation and liver biopsy at 6 and 12 months, then yearly aft er transplantation. Results: The cumulative 84 month survival rate was identical in patients tr ansplanted for alcoholic (51%) and nonalcoholic cirrhosis (52%), No differe nce emerged between anti-HCV negative vs. positive alcoholic cirrhosis pati ents, Psyche-social evaluation revealed alcohol recidivism in 11/34 long-te rm survivors, but this did not affect overall survival rate in patients wit h or without HCV. In anti-HCV negative cases, fatty changes and pericellula r fibrosis were significantly more common in heavy drinkers than in occasio nal drinkers and abstainers. When HCV status was considered regardless of a lcohol intake, fibrosis was significantly more frequent in patients with HC V. Conclusion: Alcohol recidivism after transplantation in alcoholic cirrhosis patients does not affect survival, irrespective of HCV status. Fatty chang es and pericellular fibrosis are the most relevant histological signs of he avy alcohol intake. (C) 2001 European Association for the Study of the Live r. Published by Elsevier Science B,V, All rights reserved.