Comparison of 1-Year Morbidity Following Liver Transplant for Acute Alcoholic Hepatitis Versus Alcoholic Cirrhosis
| Autor: | M. Kinkhabwala, Oya M. Andacoglu, Clara Y. Tow, Jack Liu, John F. Reinus, Carlos Figueredo, Kristina R. Chacko, Umut Ozbek |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Alcoholic liver disease medicine.medical_specialty Alcoholic hepatitis Severity of Illness Index Gastroenterology End Stage Liver Disease Liver disease Liver Cirrhosis Alcoholic Recurrence Internal medicine medicine Humans Retrospective Studies Transplantation Hepatitis Alcoholic business.industry Odds ratio Perioperative Middle Aged medicine.disease Liver Transplantation Cohort Morbidity Complication Acute Alcoholic Hepatitis business |
| Zdroj: | Experimental and Clinical Transplantation. 19:439-444 |
| ISSN: | 2146-8427 1304-0855 |
| DOI: | 10.6002/ect.2020.0189 |
| Popis: | With limited data on the morbidity profile of liver transplant as therapy for alcoholic hepatitis, we compared 30-day and 1-year morbidity in liver transplant recipients with alcoholic hepatitis versus alcoholic cirrhosis.We retrospectively reviewed 38 perioperative variables in patients with alcoholic hepatitis (n = 15) and with alcoholic cirrhosis (n = 46). Multivariable analysis was performed to identify factors independently associated with outcomes.Patients with alcoholic hepatitis were younger (43 vs 58 years; P = .001), with higher pretransplant Model for End-Stage Liver Disease scores (36 vs 29; P = .009) and worse Karnofsky scores (20 vs 50; P.001). All patients with alcoholic hepatitis received standard criteria deceased donor grafts; however, in the alcoholic cirrhosis group, 64% received standard criteria deceased, 11% living, 11% after cardiac death, 9% extended criteria, and 2% split graft donor organ donations (P.05). The alcoholic hepatitis group had higher degree of steatosis on explant (P.005), and the alcoholic cirrhosis group had higher 30-day reoperation rate (P = .001); however, 1-year interventions, vascular and biliary complications, graft and patient survival, and all other variables were similar (P.05). Rates of alcohol relapse, 1-year infection, and 1-year rejection were higher but not significant (P.05) in the alcoholic hepatitis group. Thirty-day reoperation (odds ratio of 82.63; 95% CI, 8.02-3338.96; P = .002) and Karnofsky scores (odds ratio of 1.18; 95% CI, 1.08-1.36; P = .006) remained significant on multivariate analysis.Our results showed significant differences between our patient groups, including worse functional status in the alcoholic hepatitis group but significantly higher 30-day reoperation rates and more variable grafts in the alcoholic cirrhosis group, although both groups had similar overall 1-year complication and survival rates. Although not significant, patients with alcoholic hepatitis had higher alcohol relapse and 1-year infection and rejection rates. A larger cohort is necessary to confirm the strength of these findings. |
| Databáze: | OpenAIRE |
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