Liver transplantation for alcoholic hepatitis: update

Purpose of review Alcoholic liver disease continues to be a major public health concern in the United States and around the world. Alcoholic liver disease remains the third most common indication for liver transplantation in the United States. Mortality has been reported in up to 30–50% of patients with severe alcoholic hepatitis. Liver transplantation can be lifesaving for patients with alcoholic hepatitis. Liver transplantation for alcoholic liver disease was traditionally only considered in patients who have achieved 6 months of abstinence. The majority of patients with severe alcoholic hepatitis who fail medical therapy will not live long enough to meet this requirement. The purpose of this review is to provide an update from the most recent peer reviewed articles regarding early liver transplantation of alcoholic hepatitis. Recent findings This review shows that liver transplantation offers the best survival benefit to patients with alcoholic hepatitis. Selection criteria is a key component for a successful transplant. No change in 1-year graft survival between patients who have 6 months sobriety vs. those transplanted prior to 6 months abstinence. Liver transplantation is limited by very narrow selection criteria and limited long-term data. Summary Liver transplantation offers the best survival benefit to patients with alcoholic hepatitis. Selection criteria of patients has evolved and have become more permissive and the period of sobriety has become less ...
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

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This study aimed to analyze clinical and laboratory parameters and their association with long-term outcomes in patients who underwent liver transplantation for hepatocellular carcinoma treatment, according to the etiology of the underlying chronic liver disease, in order to identify predictors of response to this therapeutic modality. METHODS: Demographic, clinical, and laboratory data from a cohort of 134 patients who underwent orthotopic liver transplantation for hepatocellular carcinoma treatment at a referral center in Brazil were retrospectively selected and compared according to the etiologic group of the underlying...
Source: Clinics - Category: General Medicine Source Type: research
Background and aim: Cirrhosis is a major public health problem worldwide. The prevalence of cirrhosis is various in different geographical regions. The aim of the present study was to determine the distribution of the etiologies of cirrhosis and their proportional changes through recent 11 years in Iran. Methods: In this retrospective, observational study, the data of cirrhotic patients who have been listed for liver transplantation in the Namazi Transplant Center (Shiraz, Iran) between January 2006 and December 2016 were analyzed. Demographic and clinical data of the patients including model for end-stage liver disea...
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research
Conclusions. Older NASH patients (≥65) have an increased risk of waitlist and posttransplant mortality compared to younger individuals, although outcomes were similar to patients with ALD or HCV of corresponding age. These individuals should be carefully evaluated prior to LT, considering their functional status, renal function, and cardiovascular risk. Further studies are needed to optimize outcomes in this growing population of transplant candidates.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
CONCLUSION: Despite advances made in the management of HE patients continue to have poor survival. Thus, in all patients presenting with HE the appropriateness of orthotopic liver transplantation should be considered. PMID: 32476788 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Non-alcoholic fatty liver disease is the most common cause of liver disease in the United States, and is estimated to affect up to a quarter of adults in the world. It is defined by excess fat accumulating in the liver and usually occurs in people with obesity, high blood sugars (diabetes), abnormal cholesterol or triglyceride levels, or high blood pressure. These disorders often run together and as a group are called metabolic syndrome. The “non-alcoholic” part of “non-alcoholic fatty liver disease” is important to distinguish it from alcohol-related liver disease, which can also cause excess liver...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diet and Weight Loss Digestive Disorders Source Type: blogs
Abstract Alcoholic liver disease is a consolidated indication for liver transplantation, but many unsolved issues can be highlighted. Patients with alcohol use disorder develop peculiar comorbidities that can become contraindications for transplantation. Moreover, a number of social and psychological patterns should be evaluated to select candidates with a low risk of alcohol relapse and adequate post-transplant adherence. In this context, the 6-month rule is too rigid to be widely applied. A short period of abstinence (1 to 3 months) is useful to estimate recovery of liver function and, possibly to avoid transpla...
Source: The Korean Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Korean J Intern Med Source Type: research
CONCLUSIONS: Liver transplant candidates covered by Medicare or Medicaid have poorer wait-list outcomes and higher posttransplant mortality. PMID: 32270989 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - Category: Health Management Authors: Tags: Am J Manag Care Source Type: research
UPDATE OF LIVER TRANSPLANTATION - NEWER ASPECTS. Turk J Med Sci. 2020 Mar 28;: Authors: Metin RO, Şimşek C, Gürakar AÖ Abstract Liver transplantation (LT) remainsas the only therapeutic option offering gold standard treatment for end-stage liver disease (ESLD) and acute liver failure (ALF), as well as for certain early-stage liver tumors. Currently, the greatest challenge facing LT is the simple fact that there are not adequate livers for all the potential patients that could benefit from LT. Despite efforts to expandthe donor pool to include the living and deceased donors, organ shortage i...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
Alcohol Damage to the Liver – What Happens? Alcohol use disorder and heavy drinking present many harmful health risks. They can include everything from high blood pressure to fatal seizures. One of the most well-known health risks that come along with prolonged heavy drinking is liver damage. How does alcohol impact the liver, and what types of alcohol damage to the liver are there? In order to better understand alcohol damage to the liver, it is important to learn how the liver processes alcohol. According to MyDr, there are 2 ways that alcohol can be processed by your liver: Most alcohol is broken down, or metabol...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Alcohol Alcohol Rehab Information Alcoholism Detox Resources for Alcohol and Drugs/Opiates alcohol abuse alcohol dependence alcohol detox alcohol treatment alcohol treatment center alcohol treatment facility Source Type: blogs
An electronic algorithm was used to flag patients with HCV risk markers for testing Related items fromOnMedica Widespread hepatitis C screening may do more harm than good Earlier transplants for liver disease kids may cut brain damage risk Significant fall in Hepatitis C deaths Doctors urge government to act on rising alcohol impact Benefits of statins 'still outweigh risks'
Source: OnMedica Latest News - Category: UK Health Source Type: news
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