1. Poor Outcomes after Recidivism in Living Donor Liver Transplantation for Alcohol-Related Liver Disease.
- Author
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Choudhary, Narendra S., Saraf, Neeraj, Dhampalwar, Swapnil, Saigal, Sanjiv, Gautam, Dheeraj, Rastogi, Amit, Bhangui, Prashant, Srinivasan, Thiagrajan, Rastogi, Vipul, Mehrotra, Saurabh, and Soin, Arvinder S.
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LIVER transplantation , *ALCOHOL-induced disorders , *LIVER diseases , *GRAFT rejection , *RECIDIVISM , *HEPATORENAL syndrome , *JAUNDICE - Abstract
Recidivism in patients who underwent liver transplantation for alcohol-related liver disease (ALD) is shown to be associated with poor survival in some studies. Living donor liver transplantation (LDLT) recipients for ALD with at least 2 years of follow-up and history of significant alcohol relapse were included. The recipients underwent LDLT from June 2010 to December 2016, and data were analyzed until June 2019. The cohort had a median follow-up of 54 (33–78 IQR) months. Recidivism (significant alcohol intake) was defined as >21 units per week. A total of 27 of 463 (5.8%) LDLT recipients (all men), aged 43.5 ± 9.6 years, had significant alcohol intake. A liver biopsy was performed on demand in 14 patients (in the presence of raised levels of liver enzymes or jaundice). The histological diagnoses in these patients were as follows: alcoholic hepatitis in 7 (50%), alcoholic hepatitis and acute cellular rejection or chronic rejection in 4 (28.5%), cirrhosis in 2 (14.2%), and acute cellular rejection and cirrhosis in 1 (7.1%) patient. Four of 5 patients with a biopsy diagnosis of acute or chronic rejection were noncompliant with immunosuppression. Six of these patients died. The mortality after 1 year of transplant was significantly more in patients with recidivism. Recidivism was associated with significant morbidity and mortality after liver transplantation. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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