Clinical

Recurrent alcohol damage unlikely post liver transplant

Last Updated: 2007-05-31 11:10:27 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Most patients who have undergone liver transplantation because of alcoholic cirrhosis are not likely to experience recurrent alcohol-related liver disease, French researchers report in the May issue of the American Journal of Gastroenterology.

Dr. Jerome Dumortier and colleagues at Hopital Edouard Herriot, Lyon, note that transplantation in these patients improves survival. However, some investigators have suggested that alcohol recidivism might also have a substantial clinical impact.

To investigate further, the researchers retrospectively studied data on 305 patients who had had liver transplantation at their institution because of alcoholic cirrhosis.

The global survival rate was 92.6% at 1 year and 73.4% at 10 years. This, the investigator note, is similar to the 88.8% 1-year survival and the 74.7% 10-year survival seen in patients who received transplants because of other types of cirrhosis.

Thirty-seven of the patients (12.1%) resumed alcohol consumption. At 1 year, 96.9% were alcohol free and at 10 years, 81.3% were still alcohol-free.

The researchers note that only about 3% of deaths were associated with alcoholic cirrhosis.

The investigators diagnosed de novo cases of cancer in 35 patients (11.5%). Male sex, history of smoking and de novo cancer were significantly associated with risk of increased mortality.

The researchers add that the long-term survival may be reduced in these patients because of tobacco and alcohol damage to other organs. Aero-digestive malignancies, they conclude, "are greater causes of morbidity and mortality than is recurrent alcohol liver disease."

In comments to Reuters Health, Dr. Dumortier pointed out that although benefits have been established, some questions were raised but not answered by the study. This includes what the ideal screening method is for detecting small neoplastic lesions of the aero-digestive tract post-liver transplant.

Am J Gastroenterol 2007;102:1032-1041.