In patients with a first episode of severe alcoholic hepatitis non-responsive to medical therapy, early liver transplant increases 6-month survival

Commentary on: Mathurin P, Moreno C, Samuel D, et al.. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med 2011;365:1790–800. Context In its most severe form, alcoholic hepatitis is associated with jaundice, coagulopathy, leucocytosis and rapid deterioration to death.1 When used in conjunction with abstinence from alcohol, corticosteroids improve 6-month survival for such severely affected patients.2 Treatment failures are identified after 7 days of therapy, using a simple mathematical instrument (http://www.lillemodel.com).3 Patients with alcoholic hepatitis who are unresponsive to medical management have a dire 6-month mortality. Widely-used selection rules exclude patients with alcoholic hepatitis from liver transplantation (LT) unless they demonstrate 6 months of abstinence from alcohol.4 5 The study by Mathurin et al used early LT to examine the survival benefits of early LT among patients with severe alcoholic hepatitis with less...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Liver disease, Epidemiologic studies, Immunology (including allergy), Hepatitis and other GI infections, Radiology, Hepatitis (sexual health), Surgical diagnostic tests, Clinical diagnostic tests Therapeutics Source Type: research