RAPIDLY PROGRESSIVE LIVER INJURY AND FATAL ALCOHOLIC HEPATITIS OCCURRING AFTER LIVER TRANSPLANTATION IN ALCOHOLIC PATIENTS
| Autor: | Thomas D. Schiano, H Conjeevaram, Alfred L. Baker, Alex S. Befeler, J M Millis, K. Dasgupta, Trevor Lissoos, John Hart |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Hepatitis Viral Human Biopsy medicine.medical_treatment Alcoholic hepatitis Liver transplantation Gastroenterology Liver disease Internal medicine medicine Humans Retrospective Studies Hepatitis Transplantation medicine.diagnostic_test Hepatitis Alcoholic business.industry Liver Diseases Hepatitis C Middle Aged Hepatitis B medicine.disease Liver Transplantation Surgery Alcoholism surgical procedures operative Liver Liver biopsy Female business Viral hepatitis |
| Zdroj: | Transplantation. 67:1562-1568 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/00007890-199906270-00010 |
| Popis: | Alcohol-related liver disease (ALD) is a common indication for orthotopic liver transplantation (OLT) in adults. Although return to 'heavy drinking' post-OLT is believed to be uncommon, the prevalence and severity of alcohol-related liver injury in such patients is not well characterized. We retrospectively reviewed the records of 68 adult patients who underwent OLT for ALD to determine the incidence of return to heavy drinking and to assess their clinical outcome. Follow-up ranged from 8-99 months (mean 42) post-OLT; 54 patients were followed for > or = 12 months. Ten patients (15%) had evidence of coexisting viral hepatitis (hepatitis C in 9 and hepatitis B in 1) before OLT. Six of 68 patients (8%) returned to heavy drinking post-OLT, and three of those died of alcoholic hepatitis at nine months, 2.5 and 3.5 years after OLT. In two of these three patients, premortem liver biopsy showed histologic features of alcoholic hepatitis in addition to bridging fibrosis or cirrhosis. None of the three patients who died of ALD had coexisting viral hepatitis. Of the 57 patients surviving for > or = 3 months post-OLT, 4 of 8 patients (50%) with steatosis and Mallory bodies in their native livers returned to heavy drinking compared to only 2/49 (4%) without these histologic findings (P |
| Databáze: | OpenAIRE |
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