Early Liver Transplantation for Severe Alcoholic Hepatitis

Dig Dis Sci. 2020 Jun;65(6):1608-1614. doi: 10.1007/s10620-020-06159-9.

Abstract

Although alcohol-associated liver disease has long been a major component of the liver disease landscape, it was overshadowed by chronic hepatitis C until recently. Nevertheless, with the declining incidence of hepatitis C in the wake of highly effective antiviral therapy, attention has shifted to the increasing burden of alcohol-associated liver disease. The incidence of advanced alcohol-associated liver disease, including acute alcoholic hepatitis and alcohol-associated cirrhosis, is rising in parallel with increasing rates of alcohol use disorders. As a result, alcohol-associated liver disease is now one of the most common indications for liver transplantation. Rates of liver transplantation for acute alcoholic hepatitis are rising as well in spite of the sparse guidance regarding candidate selection, counseling, postoperative care, long-term follow-up, and other best practices. To this day, liver transplant for acute alcoholic hepatitis remains a hotly debated clinical controversy.

Keywords: Alcohol use disorder; Alcohol-related liver disease; Cirrhosis; Relapse.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Alcoholism / complications
  • Female
  • Graft Survival
  • Hepatitis, Alcoholic / pathology*
  • Hepatitis, Alcoholic / therapy*
  • Humans
  • Liver Cirrhosis, Alcoholic / complications
  • Liver Diseases, Alcoholic / pathology*
  • Liver Diseases, Alcoholic / therapy*
  • Liver Transplantation*
  • Male
  • Patient Selection
  • Treatment Outcome